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Doctors prevail in liver donor malpractice case

Timothy Wilson, with his wife, Susie. He died a year after the liver transplant that left his brother-in-law dead.
Timothy Wilson, with his wife, Susie. He died a year after the liver transplant that left his brother-in-law dead.

A jury has found in favor of three surgeons in a malpractice case that resulted from the death of a liver donor at Lahey Hospital & Medical Center in 2010.

The 12-member jury deliberated for about three hours Thursday in Middlesex Superior Court in Lowell. Jurors ultimately rejected the wrongful death claim brought by the donor’s widow against well-known transplant surgeon Dr. Elizabeth Pomfret and two other physicians.

The death of Paul Hawks, who donated 60 percent of his liver to his brother-in-law, had far-reaching repercussions. It divided two families, and shook the busiest living liver donor transplant program in the country, which had never lost a donor. The hospital later improved its informed consent policies and took steps to enhance its use of independent donor advocates.

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William Thompson, the attorney for Lorraine Hawks, presented two theories of the case — negligence and lack of informed consent. He argued that doctors did not provide Paul Hawks with enough information about the medical condition of his brother-in-law, Timothy Wilson. As a result, he said, Hawks could not fully weigh the potential benefit to Wilson against undergoing a risky surgery. Wilson had advanced liver cancer and died a year after the transplant.

Thompson, of the Boston law firm Lubin & Meyer, also argued that doctors were negligent during the surgery. A vein tore away from the large vena cava, a key blood vessel that is attached to the liver, and surgeons struggled to stop Hawks from bleeding. He died on the operating room table.

“We are obviously disappointed the jury didn’t see it our way,’’ Thompson said. “The Hawks family still believes that changes need to be made to the organ donation system.’’

Pomfret’s lawyer, Daniel Buoniconti, of the Boston law firm Foster & Eldridge, said in an email that “we are certainly pleased with the jury’s decision,’’ but he declined to comment further. The two other surgeons named in the case are Dr. Mohamed Akoad and Dr. Yee-Lee Cheah.

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Pomfret, a widely respected leader in the field, is now chief of transplant surgery at the University of Colorado School of Medicine. Akoad and Cheah are still listed as transplant surgeons on Lahey’s website.

Pomfret defended living liver donations to colleagues at a conference in January 2011, eight months after Hawks’s death, saying that many recipients go on “to have lives they would not have had otherwise.” But when something goes wrong, she said, “the potential price that you pay is huge . . . The [donor’s] family suffers the most in all of this. But you can’t begin to know the consequences on the team and for you at a personal and professional level. It’s extraordinary.’’

She and the hospital considered shuttering the transplant program, which was temporarily suspended after Hawks’s death, but ultimately decided it provided good results for many patients. Many transplant patients and donors “wrote me personal notes and letters saying this is a horrible thing that has happened, so sorry to hear this, but please don’t stop what you’re doing,’’ she told colleagues.

A combined state and federal government investigation in 2010 cleared Lahey of any wrongdoing in Hawks’s death. Yet during a more comprehensive evaluation of the liver and kidney transplant programs at the hospital later that year, investigators uncovered violations of Medicare rules in how the hospital obtained consent from living donors.

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Medicare requires transplant programs to provide “independent donor advocates’’ whose job is to protect the donor’s rights. But investigators, according to their report, saw one unnamed donor advocate attend meetings with the transplant team to discuss recipients. And when investigators asked one doctor, who said he was the donor advocate, how he protected the donor during the consent process, he replied that he tried to make sure the donor was not acting under duress, but that consent was the surgeon’s responsibility.

The hospital was also cited for not including recipient survival data in donor consent forms.

Lahey told federal officials it had since appointed a social worker from the hospital’s behavioral medicine department to serve as a living donor advocate, as well as significantly strengthened its informed consent procedures.

Editor’s note: This story was updated Friday to reflect comments by Dr. Elizabeth Pomfret’s lawyer, Daniel Buoniconti.


Liz Kowalczyk can be reached at kowalczyk@globe.com.