Bypass Goof Sparks Lawsuit

Another lawsuit has been filed by the family of a patient who died after heart surgery at Mary Washington Hospital.

The suit alleges that Ralph P. Holt died because he received contaminated medicine during bypass surgery last year.

The suit was filed last week in Spotsylvania County Circuit Court and brings to eight the number of suits brought by heart patients and their survivors who believe that bacteria-laden solution caused their injuries and deaths.

The Holt case is similar to a case filed in March by the family of another man who died after heart surgery. It also resembles six other cases filed Monday in Spotsylvania court.

All involve former bypass patients at Mary Washington Hospital. The cases name as defendants Central Admixture Pharmacy Services, or CAPS, the maker of the suspect medicine; B. Braun Medical, its parent company; and MediCorp Health System, parent company of the hospital.

Holt's death was one of three cases that brought about a temporary halt to heart-bypass cases at Mary Washington. Hospital officials suspended heart surgeries in September, blaming a cardioplegia solution purchased from CAPS for a cluster of poor outcomes.

Efforts to reach CAPS representatives for comment yesterday were unsuccessful. In one court document, they blame Mary Washington for the patients' problems, saying the solution was "further prepared" at the hospital.

Hospital officials deny this, saying bacteria were discovered by independent labs in unopened bags of the cardioplegia.

After Mary Washington complained about the solution, the U.S. Food and Drug Administration did inspections and ordered the temporary closure of CAPS' Lanham, Md., plant because of bacterial contamination.

The Holts' court filing also offers a glimpse at the personal side of these cases, how a relatively healthy person can enter the hospital for surgery, only to have it take an unexpected turn.

"Obviously, he was in the hospital for surgery, but he was expecting to have a long and happy life," said Charles A. Gavin, the Richmond attorney representing the Holt family.

Holt was a 75-year-old resident of Fredericksburg, the father of one son and one daughter. He and his wife, the former Dona Grise, were within weeks of celebrating their 54th wedding anniversary.

The Holts met while attending the University of Central Arkansas in Little Rock. After graduation, he entered the Marines and served tours of duty in Okinawa, Korea and Vietnam.

After his retirement in 1981, the couple settled in the Fredericksburg area and purchased The Flower Shop in Fredericksburg. They ran the business together, with Ralph Holt doing much of the book work and deliveries, and Dona Holt specializing in floral arrangements. They sold the business in 2001.

Afterward, the couple enjoyed traveling, something they had done frequently while he was a Marine.

"Ten days prior to his surgery, they were in Colorado," Gavin said.

They also enjoyed golf, playing together three or four times a week. A dream for both was to attend the Masters golf tournament in Augusta, Ga. Each year they tried unsuccessfully to purchase tickets. They were able to get tickets for the 2006 tournament.

Friends describe Holt as a vigorous man who exercised regularly and appeared younger than his years. His widow's lawsuit describes him as "in general good health, fully independent, active and loved by his family."

But he experienced a "spell" at church one day and went for a cardiac catheterization at Mary Washington on Aug. 16. The test revealed a blockage, and his physician recommended coronary artery bypass graft surgery.

Dr. John M. Armitage performed the surgery on Aug. 31.

During the surgery Armitage used a cardioplegia solution manufactured by CAPS in Lanham where the suspect material was made.

Cardioplegia is a mixture of chemical compounds routinely used during open-heart surgery to still the beating heart. It comes in a three-bag set and is administered intravenously throughout the surgery.

Holt never recovered from the bypass surgery. His blood pressure plummeted, and he bled internally. Eventually his kidneys failed. The constellation of symptoms is called systemic inflammatory response syndrome.

Armitage decided to reopen Holt's chest two days later, but his condition worsened throughout the day.

"They couldn't figure out what was going on," Gavin said.

Holt died that evening, Sept. 2.

Friends joined the family for the funeral at Fredericksburg United Methodist Church. Holt was buried at Quantico National Cemetery.

Dona Holt didn't attend the Masters tournament in April, Gavin said, and she has not played golf since her husband's death.