By Alan Barnes Toronto Star

A 16-year-old girl has been awarded a projected $15 million for lifelong care because she suffered incurable brain damage following open-heart surgery when she was almost 5 years old.

A judge has found two doctors at the Hospital for Sick Children liable for an operating mistake on Jessica Hock of Winnipeg, but has absolved the hospital and other staff of any blame.

Mr. Justice Bruce Hawkins of Ontario Court, general division, approved a structured settlement which could total more than $15 million if Jessica Hock lives to 80 years. Her life expectancy is considered normal, the court was told.

Hawkins expressed no "relative degrees of fault" between surgeon Dr. William Williams and cardiologist Dr. Jeffrey Smallhorn in his 14-page written judgment that was released Monday.

A 26-day trial was held last summer, 10 years after Art and Wilma Hock brought action against the doctors and hospital on behalf of their daughter.

Jessica recovered physically from a second operation to correct the error made in the first but it is "an utter tragedy because she sustained brain damage," said Richard Sommers, the girl's lawyer.

"She's a lovely girl" but she has the mental capacity of an 8- to 9-year-old, he said. "She'll always require supervision and care. She'll not be able to live independently."

Sommers said the award is one of the largest for personal injury.

He said it is unprecedented for a little girl to have routine open-heart surgery and end up with brain damage.

Jessica was born in Thunder Bay with a congenital heart defect - a hole in the heart - and brought to the Hospital for Sick Children for a checkup when she was one month old, the judge noted.

As part of this condition, there was a narrowing or blockage of the outlet from the ventricular chamber into the artery that takes the blood to the lungs, Sommers said.

He said it was noted during the initial examination and a decision was later made to have her return to the hospital when she was about 4 or 5, considered the best age for the necessary corrective surgery.

Hawkins found that during his examination of Jessica, two days before her first operation on May 26, 1983, Smallhorn did not identify the "muscle bundle" that was blocking the flow of blood despite the earlier finding which was available to him.

Consequently, Williams did not remove the obstruction and as a result oxygenated blood could not reach her brain and she developed brain damage, Sommers said.

Jessica was left for 2 1/2 days in the recovery room with low blood pressure and a fast heartbeat and her condition "had deteriorated to a critical level," the judge wrote.

Nothing was done until a resident came along and made the correct diagnosis, Sommers said.

He said that a second operation was carried out immediately and the blocking muscle tissue was identified and removed.

"But by then it was too late," he said.

The judge ruled that the blockage should have been seen and then removed during the first operation.

"I find on the balance of probability" the failure to remove the blocking tissue "caused the subsequent brain damage" and that "insufficient attention was paid to the repeated observations in Jessica's medical records" about the problem, Hawkins said.

"There has been no satisfactory answer as to why the corrective surgery technique applied in the second operation were not applied in the first."

Neither Williams nor Smallhorn could be reached for comment.

Sommers said they have the right to appeal the decision but he said that "given the factual findings" by Hawkins, it was most unlikely a court of appeal would interfere with the ruling.

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