Health & Medicine

Lexington gynecologist's case goes to the jury

A medical malpractice case in which an Owingsville woman accused a Lexington gynecologist of unnecessary castration — removing her healthy ovaries — without warning her of the surgery's consequences went to the jury Tuesday.

The defense argued that the doctor used sound medical judgment.

“He's done the worst thing a physician can do — he violated her trust,” said Lexington attorney Sheila Hiestand.

The plaintiff, 38 year-old Connie Grimes, wept quietly after closing arguments, leaning on her husband.

Grimes is one of six women who filed a lawsuit against Dr. Michael Guiler in 2003, saying he performed medically unnecessary oophorectomies. The cases are being tried separately.

Removing a woman's ovaries results in early menopause and leaves patients at risk for breast cancer, embolisms and dementia because they can no longer produce their own estrogen.

Guiler has previously been in the national spotlight because of other lawsuits filed in 2003 alleging he had branded “UK” — for University of Kentucky, his alma mater — on uteri before he removed them.

Grimes is seeking almost $900,000 in reparations for the aftereffects of what she thinks was an unnecessary oophorectomy. She said that while she signed a consent form, she did not fully understand the consequences of having her ovaries removed at age 31.

In an interview, Grimes said that in 2001, Guiler told her she needed to have a hysterectomy because of painful, heavy periods.

After the surgery, she said Guiler told her husband he had used his medical judgment to additionally remove her ovaries, which were “too far diseased” with endometriosis.

An oophorectomy is considered a last-resort treatment for endometriosis, a disease characterized by tissue growth outside the uterus.

Grimes' attorney also noted that Guiler performs an unusually high number of surgeries.

Guiler's attorney attributed the high surgery rate to Guiler being one of a few surgeons to perform laparoscopically assisted vaginal hysterectomies, a less-invasive procedure than a surgical hysterectomy.

However, Hiestand said that there are 14 doctors in a 30-mile radius of Lexington who perform the laparoscopic procedure, and most of them only perform 10 to 12 per year. Guiler, on the other hand, performed 120 in 2001, Hiestand said.

After the ovary removal, Grimes began to suffer from depression, hot flashes, and migraines. She had an active sex life beforehand, but her husband testified that he “felt guilty” when they had sex since the operation.

Guiler's attorney said that a diagnosis of endometriosis was reasonable, given Grimes' long-term complaints.

Grimes has had a history of pelvic pain, abnormal bleeding and pain during intercourse.

“Her complaints were consistent with endometriosis,” said Guiler's attorney, Donald Brown of Louisville. “The only definitive treatment for that is a hysterectomy and oophorectomy.”

Brown maintained that Grimes had discussions with a nurse and Guiler about the surgery, documented by the consent form Grimes signed at Central Baptist Hospital.

Grimes' complaints of loss of libido and depression, Brown said, are best explained by the “massive amounts of narcotic medication” Grimes took for migraine relief.

The Women's Care Center at Central Baptist Hospital also is a named plaintiff in the civil suit.