She moved to New York City from Jamaica as a 29 year old and within the year she felt a lump on her left breast. Over the next year and a half, Lydia Williams had mammograms, an excisional biopsy (that revealed cancer), a CT scan and chemotherapy before her doctor told her she needed a mastectomy (surgical removal of her breast) in order to tell if any cancerous cells remained.
On November 22, 2000, Ms. Williams had the surgery (a modified radical mastectomy with axillary dissection – the removal of 26 lymph nodes). Immediately following, she also had abdominal trans-flap breast reconstruction surgery which involved transferring tissue from her abdomen to try to recreate her left breast.
When the post-op pathological study was reviewed a few weeks later, it turned out that there was no cancer.
Williams then sued her surgeon and the hospital claiming that the surgery was unnecessary and that she was entitled to damages for her pain and suffering (both physical and psychological) related to the loss of her breast.
On October 3, 2008, the jury in Williams v. New York City Health & Hospitals Corp. (Supreme Court, Bronx County; Index # 14520/01) returned a verdict finding that the surgeon had committed malpractice in unnecessarily performing a mastectomy and that he did so without properly informing his patient of other options.
The jury found that Ms. Williams was not given the option of a lumpectomy (in which a small incision is made and the rest of the breast remains intact):
Williams was awarded pain and suffering damages in the sum of $6,500,000 ($3,000,000 past – 8 years, $3,500,000 future – 42 years). In a post-trial decision, Justice Cynthia S. Kern agreed with the defense that the damages award was excessive and ordered a reduction to $1,000,000.
This week, in Williams v. New York City Health & Hospitals Corp. (1st Dept. 2010), the appellate court has affirmed both the liability finding and the trial judge’s reduction of the damages award to $1,000,000.
Here are some details as to the plaintiff’s injuries:
- complete surgical removal of her left breast
- permanent scarring and disfigurement across abdomen and breast
- significant post-op pain requiring a morphine pump and constant pain to the date of trial
- chronic pain and swelling in her left arm, symptomatic of lymphedema
- restricted social and athletic activities
The appellate judges split 3-2 in their decision. The majority justified the $5,500,000 reduction of the jury award simply by referring to (but not discussing the relevance of) three prior cases that bear factual similarities and by stating that there was no trial testimony establishing that plaintiff had suffered extreme emotional distress.
Here are the three cases cited by the majority:
- Motichka v. Cody (1st Dept. 2001) –$850,000 reduced from $2,250,000 for unnecessary modified radical mastectomy
- King v. Jordan (3d Dept. 1999) – $800,000 upheld for unnecessary mastectomy
- Lopez v. Bautista (2d Dept 2001) – $1,000,000 for failure to diagnose cancer, later requiring a mastectomy
The foregoing cases are all about 10 years old and in certain respects they are factually distinguishable from the Williams case. Lydia Williams was 32 years old at the time of her trial and unmarried; whereas, Ms. Motichka was 45 years old when she underwent her mastectomy, Ms. Lopez was 42 and married and Ms. King was 52 and married. Furthermore, Ms. Williams was cancer free free after her chemotherapy and need not have suffered any disfigurement while the injuries suffered by the plaintiffs in the other cases were of degree (they would have suffered less disfigurement and less pain). The appellate judges discussed none of these facts.
The two dissenting judges found that the graphic, unsettling photos of plaintiff’s body taken a few months after the surgery (that were shown to the jury) obviated the need for any extensive testimony by plaintiff or a psychologist regarding her extreme emotional distress. They stated that extensive testimony regarding plaintiff’s emotional damages might have been overkill and that it was obvious (a "universal truth") that plaintiff’s physical injuries and disfigurement resulted in tremendous lifelong psychological damages. The dissenting judges would have approved a pain and suffering award of $4,000,000.
- Plaintiff’s attorney asked the jury for $4,000,000 in pain and suffering damages for his client (and I hear that plaintiff would have accepted $1,200,000 before trial).
- Defense counsel stated in his closing that not only was there no malpractice but also "the doctors in this case absolutely, absolutely saved the life of Lydia Williams."
- The defense argued (unsuccessfully) that there was an improper attempt to inject race into this case – plaintiff’s attorney, in his closing argument, had stated that Ms. Williams was a poor Jamaican without insurance and that poverty and race have an impact on whether patients get the option of breast conserving treatment.