Judge Orders Madigan to Pay $12.3 Million in Botched Surgery that Disfigured Child

Madigan Army Medical Center has been hit with a $12.3 million verdict after the Army admitted it was negligent and responsible for a 2015 operating room fire that severely disfigured a 13-month-old child undergoing a routine, minor surgical procedure.

The child’s face was engulfed in a fireball when a surgeon activated an electrocautery device — a sort of electric scalpel — while an anesthesiologist administered concentrated oxygen through a face mask, leaving the boy with severe burns on one side of his face and his nose, according to court documents. The child, identified by the initials B.J.P., spent 22 days in intensive care and the burn unit at Harborview Medical Center in Seattle as a result, and will require numerous surgeries and facial reconstruction throughout his life for the resulting scars, the court record indicates.

U.S. District Judge Ronald Leighton found that a U.S. Army pediatric surgeon, Dr. John Horton, and an Army anesthesiologist, Dr. Phillip Cuenca, were negligent when they did not communicate with one another about fire risk before or during the Sept. 2, 2015, surgery, which had been scheduled to remove a small, benign cyst from the child’s forehead. According to court documents, Cuenca was administering concentrated oxygen to the child via a face mask at levels approaching 90 percent — well above room-air oxygen levels of 21 percent — when Horton activated the electrocautery device, and the gas ignited.

“The United States deeply regrets that it negligently caused the September 2, 2015, operating room fire that resulted in B.J.P.’s physical injuries and sincerely apologized for the pain and suffering that resulted from this very unfortunate injury,” wrote Assistant U.S. Attorney Whitney Passmore in a trial brief submitted last month.

Emily Langlie, a spokeswoman for the U.S. Attorney’s Office, said the government would have no further public comment.

Leighton, in his findings, concluded that the health-care providers at Madigan “failed to exercise the degree of care, skill and learning expected of a reasonably prudent health care provider … and that this failure was the sole proximate cause” of the fire.

Horton, the pediatric surgeon, said in a sworn deposition that he didn’t think the accident was preventable. “I wish it was,” he told the child’s lawyers.

Jeremy Johnston, one of the family’s attorneys, said that the government was slow to acknowledge liability and that the surgeon, to this day, has not admitted anything was done wrong. The family had asked the court for up to $30 million in damages.

In its trial brief and proposed findings, government lawyers stated that “the majority of people who have suffered an injury such as B.J.P.’s go on to live well-adjusted adult lives.”

Johnston found those pleadings “absurd” and offensive. The boy is now 4 years old and is “just figuring out that his face is different,” he said.

“This is the very government this child’s father is sworn to protect,” he said. “There have been zero consequences for Dr. Horton or anyone else who was involved.”

Woody Stone, a public-information officer at Madigan Army Medical Center, said the hospital had no comment.

The documents say the team was initially unaware of the fire because the boy’s face was covered in surgical drapings, and learned of it only after a nurse anesthetist-in-training was burned himself. Photographs and testimony provided during a four-day bench trial earlier this month revealed that plastic material used to secure the drapings and keep B.J.P.’s eyes closed had melted to his face. He was airlifted from Madigan, located at Joint Base Lewis-McChord, to the Harborview Medical Center Burn Unit, where he underwent several surgeries and suffered a number of medical crises.

“He was intubated and on a ventilator,” wrote his attorneys from Evergreen Personal Injury Counsel in Tacoma. “He had been chemically paralyzed. His eyes were swollen shut. His face was swollen grotesquely.”

Now, nearly four years later, B.J.P.’s face remains badly scarred, and he faces a series of reconstructive surgeries to rebuild his eyelid and skin grafts on his nose, lips, eyelids, forehead, cheeks and mouth, according to the judge’s findings and other pleadings in the case.

Leighton broke the damages down to include $2 million for B.J.P.s “acute recovery;” $3 million for his treatment and “post-acute” recovery; $2 million for his “disfigurements, deformities and physiological damages and harms;” $2 million for his “loss of a normal life,” and provided $303,162 for future medical expenses.

The child’s parents, Tyler Porter, an active duty soldier at Joint Base Lewis-McChord, and his mother, Armani, who now lives with the child in Newport News, Va., were each awarded $1.5 million for loss of love, companionship and “parental grief, mental anguish and suffering.”

According to the documents, the couple struggled after the incident and have since divorced.