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XXXX XXXXXXXX, M.D., F.A.C.S. XXXXXXXXXXXXXXXX


XXXX XXXXX XXXXX, Suite XXX Baltimore, MD 21204 (410) XXX-XXXX


Report


I am licensed to practice medicine in the State of Maryland. I have been engaged in the private practice of surgery since 1973, and I am board certified in general surgery.


I have reviewed relevant medical records and/or other information regarding the


care and treatment rendered to XXXXXXX XXXXX at the University of Maryland Medical System during the period August 27, 2003 – October 14, 2003.


On September 2, 2003, Mr. XXXXXX underwent an operative procedure


involving the abdomen. Sponges were used during the course of the operative procedure. The operative report by the surgeon, XXXXXX XXXXX, M.D., refers to the sponge count taken at the conclusion of the operative procedure: “The lap count was reported as correct.” Furthermore, the Operative Data Re- cord states that the sponge count was “correct.” The same document indicates that XXXXXX XXXX, RN and XXXXXX XXXXXXX, RN took the initial and final sponge counts.


A CT scan of Mr. XXXXXX’s pelvis was taken on September 6, 2003. The


diagnostic report indicates “there is a high density foreign body noted. It is possible that this represents a retained sponge….” A diagnostic test report of the abdomen states: “Examination demonstrates a laparotomy pad in the right lower quadrant of the abdomen.” On September 7, 2003, Mr. XXXXXX underwent an exploratory laparatomy. During the operative procedure, the laparotomy sponge retained from the September 2 surgery, was identified and removed.


Based upon my preliminary review, it is my opinion within a reasonable


degree of medical probability, that the University of Maryland Medical System Corporation, T/A the University of Maryland Medical System, acting through its actual and/or apparent agents, servants, and/or em- ployees, XXXXXXX XXXXX, M.D., XXXXX XXXX, RN and XXXXXX XXXXXXX, RN, departed from the applicable standards of care in the care and treatment of XXXXXX XXXXXX. Specifically, it was a departure from the applicable standard(s) of care to leave a laparotomy sponge in Mr. XXXXXX’s abdomen at the end of the operative procedure on September 2, 2003. This resulted in injury to the bowel, and required surgery to remove the sponge and repair the bowel.


The purpose of this report is to provide some information regarding the


departure from the standard(s) of care. This report is not, nor is it intended to be, an exhaustive description of all opinions and conclusions, and their bases.


My opinions regarding the health care providers, and departure from


the applicable standards of care, may be modified and/or supplemented upon review of additional information and/or documents.


XXXXX XXXXX, M.D., F.A.C.S. 20 Trial Reporter Summer 2007


Complying with Walzer (Continued from page 18)


analogous to this situation when a party requests a jury trial in the district court. If timely made, all district court proceedings involv- ing that case cease, and the case is thereupon transferred to the circuit court, in accordance with Md. Rule 3-325, where the circuit court reviews the merits of that request. Just as the filing of a jury request divests the district court of jurisdic- tion to consider the jury prayer or to conduct any further proceedings, the filing of a waiver of arbitration divests the HCAO of any right to consider the validity of a certificate of merit or to conduct any further proceedings, except to transfer the claim at issue to the circuit court.


Azarian v. Witte, 140 Md. App. 70, 83, 779 A.2d 1043, 1051 (2001),aff’d, 369 Md. 518, 801 A.2d 160 (2002). This statement has questionable precedential value. First, the court of appeals accepted certiorari, and its opinion did not address the jurisdic- tional issue. Second, the court of special appeals’ interpretation contradicts the statutory language granting the extension authority to the Director or panel chair, and its failure to mention the “court.” If the Director no longer has authority after arbitration is waived, and the statute fails to grant the authority to the court, no one would have the authority. Such an interpretation would render the statutory provisions a nullity. If the defense has moved to dismiss in


a pending court case, a motion should be filed for a good cause extension. There is no clear answer whether it should be filed with the Director or the court. An- other option would be to file it in both forums, but this would create the specter of inconsistent rulings. Counsel could employ the strategy utilized in Webster v. Simmonds, by (1) filing the expert report with HCADRO; (2) not filing any mo- tion with the HCADRO for a good cause extension; and (3) requesting (or moving)


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