COUNT IV

PUNITIVE DAMAGES AGAINT RONALD GASKIN, MD

            COME NOW Plaintiffs, Velma Hardester and Mary Jo Melton, by and through their attorneys, and for Count IV of their cause of action for Punitive against Defendant, Ronald Gaskin, M.D., states as follows:

            1.         Plaintiffs incorporate Count I through III as though fully set forth herein.

            2.         That during the course of care to the Decedent, Ronald Hardester, Defendant’s, Ronald Gaskin, M.D.’s, negligence rose to the level of a wanton failure to provide such care as a reasonable and prudent healthcare provider would have used under the same or similar circumstances and through his wanton failure to provide said care    he directly and proximately caused the death of the Decedent, Ronald Hardester, in the following respects:

            A.        That on 11/15/2002 Ronald Gaskin, M.D. knew Ronald Hardester had symptoms and signs that gave him a high index of suspicion for a gastrointestinal leak, which created a high probability of death or serious injury and that immediate exploration was necessary; however, Ronald Gaskin, MD failed to intervene for 5 days;

            B.         Ronald Gaskin, M.D. knew that gastric bypass surgery poses many serious risks of death and serious injury and all patients must be provided with full informed consent prior to surgery but he failed to provide informed consent, including the informed consent he claims to customarily provide, and he failed to correct the misleading, inaccurate, incomplete, inadequate and incorrect  information provided to Hardester at the New Start seminar;

            C.        That Ronald Gaskin, M.D. ignored the advice and opinion of Dr. Hardy, M.D., that the CT Scan was consistent with a gastrointestinal leak, and the advice and opinion of Dr. Slom, M.D., that abdominal exploratory surgery was necessary to see if there was a gastrointestinal leak; however, Ronald Gaskin, M.D. failed to take any immediate steps to diagnose or treat the leak even though he knew such failure to take immediate steps would likely cause death or serious injury to Ronald Hardester;

            D.        That Ronald Gaskin, M.D. knew he was not competent to perform Roux-n-Y gastric bypass surgery based upon his leak, death, and complication rates, but he continued to: operate, misrepresent his complications rates, and fail to obtain training to improve his skills;

            E.         That in October and November 2002 Ronald Gaskin, M.D. was working as a full time surgeon for Southwest Medical Center, Inc. providing surgical services to Southwest Medical Center’s patients for  over forty hours per week while at the same time he was working as a full time New Start gastric bypass surgeon working 40 hours in a week, so that he was incapable from fatigue and overwork to perform as a competent surgeon for gastric bypass patients, including the level of competence and attention  that is required in the post operative period;

            F.         In the alternative to paragraph E above:

                        (1)        The Ronald Gaskin M.D. was being compensated as an employee of Southwest Medical Center, Inc. and was receiving benefits, including staff, office, and malpractice insurance, under a contract of employment dated 1/1/2001, without providing his bariatric surgical fees to Southwest Medical Center, Inc., as required in the contract, and without rendering surgical services to Southwest Medical Center, Inc., patients as required by his employment contract so that he was being compensated excessively and beyond reasonable compensation for the services rendered to Southwest Medical Center, Inc.;

                        (2)        That such conduct of Gaskin, M.D. was permitted by Southwest Medical Center, Inc. in consideration of various agreements between Southwest Medial Center, Inc. and Tenet Health Systems, DI-TPS, Inc. and its subsidiaries or related companies wherein the physicians who were previously employed by Tenet Health Systems DI-TPS, Inc. formed Southwest Medical Center, Inc., and undertook the obligations, duties and benefits of Tenet Health Systems DI-TPS, Inc.;

                        (3)        That under the terms of the agreement, Southwest Medical Center, Inc.’s employee physicians received a large buy out, some in excess of $600,000.00, of their employment agreements that each physician, including Gaskin, had with Tenet Health Systems, DI-TPS, Inc., as such physicians were previously employed by Tenet Health Systems DI-TPS, Inc., as salaried employed physicians, but that contract was illegal as the physicians’ compensation was excessive and amounted to payments for referral of patients to Tenet facilities, therefore necessitating cancellation by Tenet Health Systems, DI-TPS, Inc.;

                        (4)        That prior to the cancellation of said contract, Tenet Health Systems, DI-TPS, Inc. induced Gaskin M.D. to become a New Start Surgeon by allowing him to collect his full salary from Southwest Medical Center Inc. and to collect surgical fees that he generated through New Start as St Alexius Hospital was having difficulty placing a gastric bypass surgeon in the New Start Program to fulfill its need due to its advertising and substantial influx of bariatric patients, and Tenet Heath System Hospitals, Inc. was attempting to make St. Alexius Hospital a profitable hospital with the growth of programs including New Start;

                        (5)        That at the time of the buy out in January 2001, an agreement was reached among Gaskin, Tenet Health System Hospitals, Inc./Tenet St Alexius Hospital, Inc. and Southwest Medical Center, Inc., wherein each would benefit from the consideration mentioned above, and Gaskin would continue to be the New Start bariatric surgeon

                        (6)        That Gaskin acted without oversight of his competence, or surgical quality because no other surgeon could be hired at New Start, thereby allowing Gaskin to act with impunity as he was aware from the failure of Tenet Health System Hospitals, Inc. and Tenet St Alexius Hospital, Inc. to take action after high complication rates and deaths including the death of Linda Slater, which was caused by the wanton negligence of Gaskin, M.D..         

            G.         Ronald Gaskin, M.D. knew his complication rate and misrepresented

                          his complication rate;

            3.         Ronald Hardester died as a direct and proximate result of Defendant Ronald Gaskin, M.D.’s above mentioned intentional acts and his wanton failure to provide such care as a reasonable and prudent healthcare provider would have used under the same or similar circumstances and said wanton failure is an aggravating circumstance justifying the imposition of punitive damages under RSMo. § 537.080 (2004) against Defendant Ronald Gaskin, MD.  

            WHEREFORE, Plaintiffs, Velma Hardester and Mary Joe Melton, pray for judgment against Defendant, Ronald Gaskin, M.D., for punitive damages in an amount necessary to deter and punish Defendant of Twenty Million Dollars ($20,000,000.00), and whatever other relief the Court deems just and proper.