A Northeast Georgia Health System surgeon at the center of a recent $3 million medical malpractice judgment in Hall County has two open lawsuits filed against him, and a settlement was reached in December 2019 on a third case, according to county court records.

NGHS officials told The Times that these cases and the recent $3 million judgment have not affected Dr. Andrew Green’s standing with the hospital nor his ability to perform surgery within the health system.

A jury awarded the $3 million March 23 in the case of Frances Mitchell, a 42-year-old Jackson County woman who died five years ago after a surgery to remove a pelvic mass from her abdomen.

NGHS, Northeast Georgia Medical Center, Northeast Georgia Physicians Group and Green were named as defendants in the case.

The lawsuit alleged Green pierced Mitchell’s small intestine during the surgery and “failed to properly examine Frances Mitchell’s small intestine to ensure that no gastrointestinal injury had occurred before he finished the surgical procedure.”

A Times review of Hall County civil lawsuits shows there have been four total lawsuits filed against Green and the hospital in the last three years.

“We respect the patients involved in these cases and feel for anyone dealing with difficult health issues following their care,” NGHS chief legal officer Andrei Boyarshinov said in a statement. “Our goal is always to keep the focus on care in the right settings, not in the courtroom, but we believe the actions in these cases met the appropriate standards — and independent expert reviews of the cases found no evidence of negligence or malpractice. Unfortunately, these individual cases don’t reflect the thousands of people Dr. Green has helped — including the lives he’s helped save. We look forward to reaching resolution through the judicial process.”

A common theme arises in the complaints: A woman going in for surgery and experiencing a perforation of her bowel or some other type of internal incision that led to further medical complications or death.

“Risk is always assessed and discussed with patients prior to surgery,” Boyarshinov said. “Post-operative care and discharge decisions are made by the care team based on the patient’s unique situation and needs.”

Boyarshinov added that Green is one of the few “fellowship-trained gynecologic oncology surgeons in our region, and he is an extremely skilled surgeon who has more than a decade of experience leading patients with difficult, high-risk cases to positive outcomes.” 

Regarding the $3 million verdict, Boyarshinov said the health system was exploring appellate options. 

During the reporting and again before publication, The Times reached out to the hospital seeking an interview with Green about these allegations. The hospital said the only response would be Boyarshinov’s comments in response to emailed questions.

A call to Green’s office was not returned Friday, April 23.

The open cases

There are two open lawsuits against Northeast Georgia Medical Center and Green, one filed in March 2019 and another in May 2020.

Kenneth Lewis, who represented Mitchell’s children in the recent case that went to trial, is the attorney of record on the 2020 case and told The Times he was assisting the legal counsel on the 2019 case.

NGHS has broadly denied the allegations in these complaints, claimed they were without sufficient information to express an opinion on their veracity and stated the care administered met or exceeded the standard of care applicable. 

“While we would prefer to continue those conversations in a clinical setting, not a courtroom, we look forward to reaching resolution through the judicial process,” Boyarshinov said.

When asked about his involvement in multiple cases with Green, Lewis said a bad outcome doesn’t always mean malpractice.

“I’ve had multiple cases where I’ve actually gone and sat down with a doctor in Gainesville and talked about the case, and you find out that it really was just a complication or it was something like that,” he said. “I take one in 20 cases that might come across.”

According to the 2019 complaint, a Monroe woman who was 13 weeks pregnant went in March 2017 to Northeast Georgia Medical Center for a robotic-assisted operation.

After being discharged, the woman woke up with unbearable pain and bled heavily, ultimately going by EMS to an Athens hospital, according to the complaint.

“After consulting the surgeon who performed the surgery and her obstetrician, it appeared that (the woman) had suffered a miscarriage,” according to the complaint. “Prior to discharge, she passed the fetus and the placenta.”

In the days after, the woman continued to have severe abdominal pain, returning to an emergency room with a fever of 103 and a scan showing a “large amount of fluid in her abdomen,” according to the complaint.

A scan showed “that her left ureter was cut during the surgery that was performed by Dr. Green,” according to the complaint. 

Green specifically denied that the ureter was cut during surgery or that any damage was suffered to her stomach as a result of the surgery in a filed response to the lawsuit.

The lawsuit alleged the result has caused “psychological and emotional turmoil” for which she has sought professional help. Multiple attempts to reach the woman’s attorney, Alfreda Williams, for comment were unsuccessful.

According to the 2020 complaint, a woman went in March 2018 for surgery performed by Green to remove a pelvic mass.

During the surgery, Green allegedly perforated the woman’s bowel and documented it in the medical records, according to the complaint.

In a filed response to the lawsuit, Green and the hospital denied the allegation “to the extent they allege any negligence against these defendants.”

“In further response, (the) defendants state that the allegations contained in (the paragraph) are incomplete and out of context,” according to the response to the suit. “The medical records of (the woman) and the recollections of the health care professionals involved in her care are the best and most comprehensive evidence as to the truth of the allegations contained in this paragraph. Therefore, the allegations are denied to the extent they contradict the same.”

The woman was admitted to the hospital after surgery and had an emergency exploratory surgery three days later “because of acute sepsis and green drainage from her midline incision caused by the known bowel perforation … Green failed to repair,” according to the lawsuit.

“Because of the severe abdominal infection and acute sepsis and septic shock, (another doctor) had to leave (the woman’s) abdomen open, and she was transferred to the intensive care unit … (and) a ventilator was necessary to keep (the woman) alive and breathing in the ICU,” according to the complaint.

According to the complaint, the medical bills between March and July 2018 totaled $650,000.

Lewis said his client “had a long recovery period and suffers severe emotional problems from the complications.”

The settlements

According to the Georgia Composite Medical Board licensee records, there was an $800,000 medical malpractice settlement for Green in September 2019. NGHS officials said they could not comment on the settlement listed with the medical board.

No further details are offered on the medical board’s records on the settlement.

Another case filed in May 2019 was settled in December that year concerning a woman who was having her cervix removed by Green in May 2017. According to the complaint, Green noted the small bowel was damaged and he had to “throw a stitch” to repair it. The medical records also noted that the colon was “air pressure tested” at the end of surgery, which the complaint alleges and the hospital admitted in its original response.

The woman was released on May 26, 2017, and her husband called Northeast Georgia Physicians Group the following day to report his wife’s severe abdominal pain, according to the complaint.

According to the lawsuit, an unidentified member of Green’s staff told the husband that this was a “normal post-operative symptom.” This was repeated by Green the next day as well when the husband called again about his wife’s fever and severe abdominal pain, according to the lawsuit.

The hospital and Green denied these claims in their filed response.

The woman went to Northeast Georgia Medical Center in Braselton by ambulance three days after being released and was noted to be in “life-threatening condition” upon arrival in the emergency room, according to the complaint.

A doctor performed an exploratory surgery causing feces to pour out of the woman’s abdomen, according to the lawsuit. The doctor estimated 2 liters of feces were removed from the woman’s abdomen, and she reportedly suffered severe sepsis with septic shock, according to the lawsuit.

Attorneys for both sides said there was a confidential settlement in the case but did not provide any further information on the case’s disposition.

Lewis said the woman, whose case he learned about through his work in the Mitchell case, is alive but has ongoing “medical and emotional problems.”

“It’s important to point out that settlements are often reached for a variety of reasons when independent third-party reviews have found no evidence of negligence or malpractice,” Boyarshinov said.