A University of Maryland Medical Center surgeon told a jury yesterday that he was not to blame for a clamp left in a woman's abdomen during a 1992 operation to remove an ovarian cyst.
Dr. Julian P. Smith said in Baltimore Circuit Court before Judge Edward J. Angeletti that he did not know how the 6-inch clamp ended up in the abdomen of Linda Haines, a Harford County woman, during the surgery on Aug. 24, 1992.
"My supposition is that the clamp was unseen by anybody," said Dr. Smith, who surmised that the scissors-like instrument was "swept" unnoticed into the open cavity in the woman's abdomen before doctors sealed the opening. "I truly do not think there is any other possible explanation."
Mrs. Haines, 40, is seeking more than $1 million in damages from Dr. Smith and the University of Maryland Medical System, claiming that the mistake has caused her abdominal pain, fatigue and other physical and psychological suffering. The instrument was removed a few days after the original operation.
"The University of Maryland Medical System is extremely sorry that this incident occurred and the hospital has acknowledged liability in this matter from the outset," said spokeswoman Joan Shnipper. "The only dispute is the amount of damages payable to Mrs. Haines. The hospital made a generous settlement offer, which was rejected."
Dr. Smith, a gynecological surgeon, wore his gray hair in a conservative style and was dressed in a dark gray suit as he faced the eight jurors during his testimony in the second week of the trial. Several times during his three hours on the witness stand yesterday he pointed out -- without being asked -- his 35 years of experience in the field.
Questioned by Carol A. Zuckerman, a lawyer for the doctor and UM Medical System, Dr. Smith said he performed the surgery to remove a grapefruit-size mass that was causing Mrs. Haines pain so severe that she had trouble sleeping.
He said he had recommended a 3-hour operation to prevent the growth from becoming malignant.
JTC Four of the 6-inch metal clamps were used during the surgery to hold vessels that were cut away from the ovary and fallopian tubes.
After the operation, Mrs. Haines complained of an inordinate amount of pain. An X-ray taken four days after the surgery revealed the clamp in her abdomen, and another operation was required to remove the instrument. She remained in the hospital until her discharge on Sept. 9, extending her hospital stay for 10 days.
Dr. Smith told jurors he has developed a system of handling surgical instruments. He said that the clamps were removed as he closed the cavity and that he depended on a surgical nurse to handle and account for the tools when he was finished with them.
In previous testimony, a surgical nurse said that she had accounted for all of the instruments.
"Did you ever see, during the closure, a clamp fall into or slip into or drop into the cavity?" Ms. Zuckerman asked the doctor yesterday.
"No," the doctor responded without hesitation.
Dr. Smith said he left for a fishing vacation with his sons before the mistake was discovered.
By the time he returned, the woman had undergone the operation to remove the clamp. He said he visited Mrs. Haines after his return.
"I'm sure I told her the clamp was left in and that I had no idea how it was left there. I told her I was very sorry," he recalled.
The surgical nurse and the two surgical residents who assisted Dr. Smith in the operation were not named as defendants in the lawsuit.