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A Tale of Tragedy and Justice

Medical Malpractice

The case involved a loving couple who came to the U.S. from Cuba in 2013 to live with their extended families in Miami and for a better life. Three years later that American dream ended in heartbreak and the tragic, unnecessary loss of a beloved husband.  

At 6:30 pm on Friday, December 10, 2021, a Miami-Dade County jury returned justice for Maria Santana Barbero by delivering a verdict of $2,960,109.85, against Barbara Montford MD, a Miami urologist, who negligently caused the wrongful death of her 71-year old patient, Raul Barbero. 

The case was brought by Mr. Barbero’s widow, Maria Santana.  Mr. Barbero was undergoing routine prostate removal surgery.  The surgeon , Barbara Montford, negligently failed to control bleeding during surgery, allowing Mr. Barbero to lose (4) liters of blood during the procedure.  The catastrophic bleed caused multiorgan injury and ultimately Mr. Barbero’s death, after 13 days in the intensive care unit.

The average human body normally contains around (5) liters of blood. Dr. Montford allowed Mr. Barbero to lose over 80% of the total blood in his body.   

Mr. Barbero saw Dr. Montford in 2015 for advice and treatment of his prostate cancer after receiving an elevated PSA score on routine bloodwork. The defendant urologist testified she recommended numerous treatment options including surgery, both traditional and robotic, observation, radiation therapy, cryotherapy, and hormonal therapy. Mr. Barbero had a traditional open surgery to remove his prostate. The defendant urologist only performed traditional open surgery, she did not do robotic surgery, preferring instead to refer patients to doctors who did.

The jury heard evidence that Mr. Barbero had several medical conditions, including high blood pressure, cardiac issues requiring use of blood thinners, and COPD. According to a testifying expert urologist, these medical conditions made Mr. Barbero a bad candidate for a traditional open surgery where significant bleeding was expected.  He further testified that with a Gleason score of 6 following a prostate biopsy and no evidence of metastasis, other less invasive treatment options should have been recommended.  The expert noted that safer options for Mr. Barbero included continued observation and radiation therapy, but that if Mr. Barbero insisted on surgery, a robotic surgery should have been recommended rather than a traditional open procedure.

On March 1, 2016, once in the operating room, the defendant testified that she encountered a “burst” of bleeding at the surgical site. However, the defendant failed to document the amount of estimated blood loss in her operative note.  She claimed the bleeding was controlled and Mr. Barbero was stabilized. Since Mr. Barbero lost (4) liters of blood, we know the bleeding was not controlled and Mr. Barbero’s blood loss was not resolved.

In trial, Dr. Montford blamed the anesthesiologist and, although she was the surgeon-in-charge, said the anesthesiologist should have instituted blood replacement. The anesthesiologist and nurse anesthetist testified that Mr. Barbero lost 4 liters of blood, an amount of blood described as “massive” and “catastrophic.”

A pathologist who performed a private autopsy of Mr. Barbero testified that he died from a massive intraoperative hemorrhage and organ failure, with severe damage to his kidney, liver and lungs. The expert pathologist agreed with the hospital pathology there was cancer in only 5% of the prostate removed during surgery.

The expert pathologist was critical of the death certificate filled out by the Dr. Montford which stated that Mr. Barbero died of “natural causes”, namely cardiac and respiratory arrest. In the death certificate, there was absolutely no mention of the surgery, much less the surgical bleeding and resulting organ failure which caused him to die.

In her defense, the urologist testified that it was the anesthesiologists’ job to keep track of bleeding and offered expert testimony that the ICU team who treated Mr. Barbero after the surgery did not adequately resuscitate him. She also testified that she was not familiar with the hospital’s massive transfusion protocol which, if activated, would have provided Mr. Barbero additional units of blood and platelets within 15 minutes. The jury rejected the defendant’s attempt to blame others, finding that the defendant’s negligence was a legal cause of Mr. Barbero’s injury and death.

The jury was asked to evaluate Maria Santana’s loss of her husband’s companionship and protection, and pain and suffering, because of his injury and death, and assessed past damages of $960,109.85 and future damages of $2,000,000.00.

Maria Santana had offered to settle her claim against the defendant urologist for the malpractice insurance policy limits of $250,000.00.  Indeed, Ms. Santana served a proposal for settlement in that amount on October 29, 2018.  The defendant was insured by a medical malpractice insurance “consent” policy with Norcal Insurance Company. That policy contained a provision which required the “consent” of its insured physician before any offer or settlement of the claim could be made.  Evidently, the defendant never consented to make an offer to settle Raul Barbero’s case, choosing instead to expose herself and her practice to a judgment which will exceed $3 million once court costs and attorney’s fees are assessed.

The case was originally set for trial before the pandemic, postponed until November 1, 2021, but then reset to begin on December 6, 2021 at the Main Courthouse in Downtown Miami, which coincided with its reopening following structural inspections prompted by the Surfside Condominium collapse.

It required (5) years before Mrs. Barbero would be given justice. A jury finally delivered that justice. Though this will not bring back her husband, Mr. Barbero’s tragic death was addressed in the only way our system permits.  

Ms. Santana was represented by Mariano Garcia, Edward Ricci, Juan Diaz and Boris Zhadanovskiy of Searcy Denney Scarola Barnhart & Shipley, PA.

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