Ex-Lineman Sues UCLA Physicians

For Dennis and Nancy Brewster, the past five years have been a time of hopes raised and dashed, as Dennis, a former professional football player, underwent 30 operations on his right knee and finally, the amputation of his leg.

Now, the Brewsters, who live in Arcadia, are hoping again: hoping that a jury in Santa Monica will side with them in their $25-million medical malpractice suit against Brewster’s former doctors, UCLA and its medical center, and the manufacturer of an artificial knee that purportedly was custom-designed to fit the bulky former lineman.

Their tale has been unfolding for three weeks before a jury in Superior Court. “It went from bad to worse,” the Brewsters’ lawyer, Kevin McLean, said of the treatment Dennis Brewster received.

The defense, meanwhile, contends that the care was proper all along and that the 350-pound Brewster was simply more at risk than the average-size patient.

Brewster, 47, lettered in football at Brigham Young University in the mid-1960s. He was drafted by the Chicago Bears in 1966 and played intermittently for a few years alongside the likes of Mike Ditka and Dick Butkus. Picked up by the Rams in 1969, he played in a couple of preseason games for the Los Angeles team before sustaining a career-ending knee injury.

After football, Brewster enrolled in podiatry school and eventually built up a solo practice in Arcadia, where his wife worked as the office manager. But in the fall of 1985, arthritis in his knee caused Brewster to consult doctors at UCLA.

Dr. Eric Johnson, professor of orthopedic surgery at the university, recommended replacing his knee with a steel and plastic prosthesis. To fit Brewster, it would be custom-made by Howmedica Inc. of New Jersey, a leading manufacturer of prosthetic devices.

“Johnson said in two months, I’d be back at work and active,” Brewster testified this week.

But about an hour into the surgery in February, 1986, Johnson, assisted by Dr. Michael Tooke, determined that the Howmedica knee would not be such a good fit, according to attorney McLean. Johnson left the operating room, called Howmedica and complained, and phoned a Glendale company to get an off-the-shelf artificial knee. About an hour later, the surgery resumed, and the knee from Glendale was installed. The operation, which should have taken three hours, lasted twice as long, McLean said.

Within five days, the prosthetic knee became partially dislocated. Brewster was outfitted with a cast, but the device continued to slip and had to be removed. Holes were then drilled in Brewster’s leg to affix braces, but the leg swelled up. Infection had set in--although it remains in dispute when and why.

At the end of May, 1986, Brewster stopped going to Johnson and went to doctors and Huntington Memorial Hospital in Pasadena. But, according to McLean, the infection never let up. Brewster underwent 16 operations over 3 1/2 years aimed at treating the infection. Finally, in January of this year, doctors at Orthopaedic Hospital in Los Angeles amputated the leg at mid-thigh.

The case is expected to go to the jury by the end of this week. The jurors have heard from nearly two dozen witnesses and have viewed not one, but three, plastic models of the knee. The aging yet flamboyant Melvin Belli, with whom McLean is associated, has attended at times.

Belli was ordered out of the courtroom Monday by Judge Joel Rudof when he called a defense lawyer “the sleaziest man I’ve ever seen” for bringing up evidence that was damaging to Brewster and that the judge later excluded as unfair.

McLean, meanwhile, has presented evidence and testimony intended to show that Howmedica was at fault for making a knee that did not fit. The infection, he argued, stemmed from the 70-minute interruption in the operation in which “everyone was hanging out while waiting for this device from Glendale.”

Johnson, the UCLA surgeon, failed to give Brewster adequate antibiotics afterward, McLean contends. “They gave Dennis the dosage of a normal person; he’s twice the size of a normal person.” The low dosage only suppressed the infection rather than killing it, the attorney said.

The follow-up examinations and surgeries were no better, McLean said, noting that during one operation, a drill bit broke off in one of Brewster’s bones.

“The risks could’ve been a little large because of his size. But he was not aware that would increase the risk to being 100% guaranteed--and that’s what happened.”

Brewster, who wears custom suits, “needed a custom operation, as well as a custom device, (and) custom follow-up. He needed custom everything,” McLean said.

Attorneys for Howmedica and UCLA argue, however, that the Howmedica device could have fit, and that it was simply a judgment call by the doctors to use the Glendale device, which fit even better.

“When you have bone subject to molding by a device, you have a wide range of sizes that could be used,” said Howmedica lawyer Bruce Gridley. “We needn’t put ourselves into a world where we assume only one size is right.

“Delays in surgery, while getting the appropriate tool or instrument (are) common,” he added. “Not every hospital can have everything.”

During the delay, Brewster’s knee was covered and sprayed with antibiotics, the defendants contend.

UCLA attorney George E. Peterson contends that it was muscle spasms and Brewster’s skin rubbing against the cast after the operation that led to a sore, which became what he called the “portal of entry” for the infection.

The pressure of Brewster’s weight contributed to the sore and was out of their control, the defendants say. “It’s not within Johnson’s field to make Brewster a thin man,” Gridley said.

Brewster, his eyes teary and voice faltering, testified from his wheelchair that his infection is still present. Every day, his wife cleans the stump, and he leans over, “(squeezes) the end of the stump, and this (infectious) fluid comes out,” he said.

His current doctors “don’t know if they’ll ever get it under control,” McLean said.

Ramps have been installed in the Brewsters’ home in Arcadia, and the doorways have been widened to accommodate wheelchairs. Brewster uses a portable toilet because he cannot maneuver from his wheelchair to the bathroom toilet, he testified.

Even going to the movies is a “major undertaking,” Nancy Brewster said in an interview. When his leg was in braces, Brewster would sit in the theater “with his leg out, because it was stiff. Several times, people would try to get though, and say, ‘Move your leg! Can’t you move your leg?’ ” Nancy Brewster recalled.

Now that Brewster is confined to a wheelchair, people stare, she said. The family avoids the Saturday night movies and instead goes to matinees.

“We just don’t go out like we used to,” she said. “It was such a hassle, and such an emotional thing to do, that we just quit. . . . You don’t need to be reminded.”

Brewster spends much of his days watching television. Nancy has become his caretaker, and they and their three children have been living off savings and $1,000 a month of disability payments, she said. The medical bills have mounted to $400,000, with insurance covering $300,000 of it. Brewster said in court that his future medical treatment will cost “several million dollars.”

Before the knee replacement surgery, Brewster’s podiatry practice had brought in about $250,000 a year, with Brewster’s salary about $45,000 a year, McLean said. He stopped working in December, and says he is unable to work because he might pass along his infection to a patient.

“There are not that many people who want to go to a one-legged podiatrist anyway,” McLean said.

The lawsuit asks for $5 million in lost wages and $20 million to compensate for the Brewsters’ pain and suffering.

The defendants contend that Brewster could resume his practice, and note there are wheelchair-bound doctors who still perform surgery.

“It’s a tragedy the man lost his leg. I think anyone can understand it on human terms,” UCLA lawyer Peterson said. But that, he said, doesn’t make for malpractice.

“They screw his life totally (and) they’re not even going to take responsibility to make it comfortable,” countered McLean. “It’s not (as if) he has a broken arm.”