Jeff Vaughn

1
Jeff Vaughn v. Kentuckiana Colon Rectal Surgery
and Dr. Wayne Tuckson
2
Dr. Tuckson cut out Jeffs Benign46 year old
colon Jeffs rectal bleeding in September 01
had been caused by hemorrhoids
PROVEN FACTS FAP death from
cancer unless colon is cut out ?
Jan 30, 2002 sole office visit with Dr.
Tuckson before surgery ?
March 19, 2002 Dr. Tuckson cut out colon with
presumed diagnosis
-Discharge Summary (Ex. 28) -Dr.
Tucksons April 17, 2002 letter (Ex. 29)
Jeff did not have FAP and Dr. Tucksons
documents did not support FAP
3
Credibility 3 Key Facts the Defense Fought with
Fiction
?FAP Misdiagnosis was Jeff misdiagnosed with
FAP?
?Hemorrhoids did they cause Jeffs rectal
bleeding?
?Litigation Fear is this why Jeff not told he
had AFAP?
?

4
Dr. Tuckson cut based on hearsay from patient
Jeff Dr. Tuckson cut with Jeffs statement and 4
documents
January 31, 2002 Office Visit - Jeff said Dr.
Haider said Jeff had familial
polyposis more than 100
polyps
?
?

Dr. Tuckson had 4 reports - that identified a
total of 2 polyps
1. EGD Path Report not consistent with FAP
2. EGD Report not consistent with FAP
3. Colonoscopy Path Report unclear at best
4. Colonoscopy Report not consistent with FAP
Standard of Care Jeffs statement alone is
NOT an acceptable way for Dr. Tuckson to confirm
FAP diagnosis.
5
Documents - FAP Misdiagnosis/Surgery
? (45 Days) Dr. Tuckson Chart 4 reports, 1
letter, and Jeff says FP ____ 0 Dr.
Tuckson ?Scopes, ?DNA Tests, ??? to
collect documents diagnosing FAP
Sept 21, 2001 to Jan 30, 2002
March 19, 2002 to Jan 20, 2004
______________ ______________ ? ?
? ? ?
?
(4 months)
(1 year and 10 months)
Dr. Kashif Haider Chart ? ? Includes Dr.
Lees Path ? Includes Hardin CT Scan
Dr. Tuckson Chart ?Surgery Report ?2 Office
Visits ?No mention of AFAP
Hardin Hospital Chart ? ? Includes Dr.
Lees UK Path
Jewish Hospital Chart ?No mention of AFAP

HealthSouth Surgery Chart ? ?Photos b4 litigation?
Mayo Clinic 1/20/04 ?Jeffs lawyer gets DNA
tested
6
1. EGD Path Inconsistent with FAP 1/22/02
Pathology Report faxed to Dr. Tuckson on Jan 30th

Fax received at 1001p.m. ?
? Heartburn
?Infectious Organisms Not Seen
?Stain for Bacteria Negative
7
2. EGD Heartburn, not FAP 1/22/02 Operative
Report faxed to Dr. Tuckson on Jan 30th
Fax received at 123p.m. ?
Before Scope Diagnosis 1. Persistent heartburn 2.
Possible familial polyposis
??????????

• After Scope Diagnosis
• Heartburn
• ?not familial polyposis

??????
8
3. Colonoscopy Path Unclear at Best 10/12/01
Pathology Report faxed to Dr. Tuckson on Jan 30th

Fax received at 123p.m. ?
? 1 documented polyp
??
Low to High Grade Dysplasia? Either low or
high not both Moderate to Severe Dysplasia? no
more moderate Either low or high
9
4. Colonoscopy Report Inconsistent with
FAP 10/11/01 Report faxed to Dr. Tuckson on Jan
30th
Fax received at 123p.m. ?
Before Scope Diagnosis 1. Rectal Bleeding
??????
???
After Scope Diagnosis 1. Hemorrhoids 2. Colon
Polyp x 2
10
Dr. Tuckson never told Dr. Haider the surgery date
Red Flags Index Case no
family History Polyps Not Evenly
Distributed Low to High Severe?
?

11
Jeffs did not have a deadly disease, he had
Hemmorhoids
_________________________________
12
Dr. Tucksons Fault
Dr. Tuckson failed to exercise reasonable care
in treating Jeff because he failed to confirm
the diagnosis before cutting.
Dr. Tuckson was required by standard of care to
confirm diagnosis (1) Contact Dr. Haider
(2) Order DNA testing (3) Take a
look himself
Dr. SussmanSurgical Oncologist UC
Dr. Rex.GI IU
13
(1) Contact Dr. Haider - what would a ?have
revealed?
?Dr. Lee had argued no way Jeff had FAP in
early Jan 02 p. 21
?Polyposis not on Lees mind
_______________________
?Dr. Haider said Jeff had less than 100 polyps
and no history p. 39
___________________________
_________________
? ? ? ?
p. 45
14
(2) DNA Testing - what would a Mayo test have
shown?
? A mutation was NOT detected
________________________________________
________________
15
(3) Look Inside Colon First what would Dr. T
have seen?
? Benign segment of colon
? No adenoma or carcinoma
? Benign segment of colon
16
Dr. Haiders Fault
What have the Defendants proven as to Dr.
Haiders fault?
17
Apportionment of Fault and Jeffs
Damages Example of effect of apportionment on
damages awarded

• Defendants Pay
• Total Damages 1,000,000
• Dr. T Fault x 50
• Dr. T Owes Jeff 500,000 ?

? Verdict Reduced 1,000,000 total
damages award reduced by 500,000 for Dr. H 50
share of fault
Jeff collects 500,000 from 1,000,000 awarded
in this 50/50 example.
18
THIS CASE IS ABOUT AFAP
About Defendants
A
Faulting
F
Another
A
Person Dr. Haider
P
19
THIS CASE IS ABOUT AFAP
About Defendants
A
Fabricating
F
A
A
Polyposis AFAP
P
20
Attenuated FAP Defense born by law suit Dr.
Tuckson never mentioned it but now says Jeff had
AFAP
Time Line - Jeff not told he had AFAP at
Jan 30, 2002 - Office Visit with Dr.
Tuckson March 19, 2002 - Surgery with Dr.
Tuckson April 17, 2002 - Office Visit with Dr.
Tuckson July 3, 2002 Office - Visit with Dr.
Tuckson No mention of AFAP in medical records

?

?

July 15, 2003 Dr. Tuckson Deposition Jeff hears
AFAP a year after his last Office Visit
21
FAP and AFAP very rare and even rarer
Entire Population 100? ?????
?????
Colon cancer 5 ??
_________________
FAP lt 1 of 5? ?
AFAP 2 of lt 1 of 5??
AFAP with Desmoids 3 of 2 of lt 1 of 5?.
22
What does the Mayo Clinic say about AFAP?
? None of the listed mutations were detected
________________________________________________
_____
23
What does Dr. Churchs article say about AFAP?
Fundic Gland polyps are nearly always
associated with AFAP and may precede the
development of colorectal polyps.
Jeff did NOT have Fundic Gland Polyps Undisputed
Fact per EGD
AFAP article, p. 130, January 2002 Dr. Church
did not mention of controversy in commentary
24
What else does the article say about AFAP?
In addition, screening with flexible
sigmoidoscopy the recommended modality for FAP,
is inadequate, because the majority of colonic
lesions in patients with AFAP are right sided.
Jeff had left sided polyps ?
AFAP article, p. 130 January 2002 Left sided
Polyps and AFAP not discussed in Dr. Churchs
commentary
25
Jeff had 3 Small Low Grade Adenomas 3 ant size
adenomas do not equal AFAP
Dr. Fenoglio-Preiser 1 low grade ant-size
adenoma
Specimen to Pathology 1 piece of tan tissue (.6
x .02 x .02 cm)
1. Colonoscopy 2 polyps 10/11/01 Dr. H
rectum scope
?
?
__________________________________________________
_______
Dr. Fenoglio-Preiser 2 low grade ant-size
adenomas
Specimen to Pathology 6 tan fragments (2.0 mm
each)
2. Flex Sig - 4 polyps 11/5/01 Dr. H
rectum scope
?
?
?
COMMON

__________________________________________________
_______
Dr. Fenoglio-Preiser 0 adenomas Jewish
Pathology Benign Colon No adenomas No carcinomas
3. Colon Removal 3/19/02 Dr. T surgery

Specimen to Pathology Jeffs Colon 3 feet
approximately
?
?
?
COMMON

26
DNA testing is powerful tool to be used to
confirm diagnosis in an atypical patient like Jeff
Hardin Memorial Request for 2nd Pathology Opinion
from Dr. Lee
__________
_____________________
______________________________
Dr. Church Primer, Chapter 9, Page 71
__________________________________________________
___________________
_________________________________________________
27
Jeffs damages the unnecessary surgery
?
28
Jeffs pain and suffering since surgery
10 Bowel Movements a Day X 365 Days in
a Year X 28 Years of Life Expectancy 102,200
Bowel Movements Left

• Jeff Can Not Eat Normally
• Jeff Wakes Up In Pain Every Day
• Jeff Can Not Control His Gas
• Jeff Has Accidents
• Jeff Carries A Diaper Bag
• Jeff Defecates Over A Dozen Times Per Day
• Jeff Has To Work More Hours To Do His Job

29
Dr. Lynch says a gross deviation from a
minimally acceptable standard of care has turned
Jeff into a bowel cripple
30
Dr. Tuckson operated the scapel which, according
to him, was the Truck In This Case