A soldier formerly based in Casper had no choice but to sue three Casper doctors in federal court for medical malpractice that nearly killed him, he said Tuesday.

"First, it was for my family," former U.S. Army Staff Sgt. Edward Poche, 39, said in an interview from his home in Byron, Ga.

"I lost my career over what happened, and [the family] had to come first," Poche said.

He and his wife, Cynthia, also wanted Wyoming residents to know they have the right to take action in similar cases, he said. "I survived; the next guy might not."

Poche's attorney, Steven Shapiro, said he partly framed the case with a public perspective. "We told the jury, 'Is this the kind of care you want in the state of Wyoming?'"

After a four-week trial ending Friday, the jury in U.S. District Court in Cheyenne awarded the Poches $1.6 million in damages - about half of what they were demanding - after finding Dr. Raoul Joubran 60 percent negligent and Dr. Mary MacGuire 40 percent negligent. The jury did not find Dr. James Anderson negligent.

The jury also awarded the federal government $380,000 in compensation for the Bethesda (Md.) Naval Hospital, which had to repair the damages caused by Joubran and MacGuire.

The doctors declined to mediate the case or take it to the Wyoming Attorney General's Medical Review Panel, Shapiro said.

In court documents and at trial, the doctors said they operated within the standard of care and their efforts saved Poche's life.

Anderson's attorney, Jeff Brinkerhoff, said he was surprised at the overall verdict, but pleased that the jury agreed his client met the standard of care.

Joubran's attorney, Scott Ortiz, did not return calls requesting comment.

MacGuire's attorney, W. Henry Combs III, said the evidence showed the two doctors were not negligent and he's considering appealing the case to the 10th U.S. Circuit Court of Appeals in Denver.

The case could have wider implications, too, Combs said. "I think this verdict will have a negative effect on health care in Wyoming."

The case

The case started when Poche, stationed in Casper with the 651st Army Reserve Quartermaster Company, went to Joubran of Gastroenterology Associates for an evaluation on July 26, 2005, because of abdominal pain from a previous surgery.

Three days later, Joubran performed procedures the Poches said were unnecessary. On July 30, Poche suffered severe abdominal pain, went to the emergency room of the Wyoming Medical Center, and had a CT scan showing a perforated small intestine. Some procedures were done, but Joubran did not request a repeat CT scan and a surgical consultation until Aug. 1, according to the complaint.

That day, MacGuire performed surgery to repair the torn intestine and to stop the spread of fluid damaging his organs. That was 67 hours after the initial procedures and more than 51 hours after Poche went to the emergency room, according to the complaint.

Poche was transferred to the intensive care unit in critical condition, and was thought to be at risk for multiple organ failure. MacGuire's surgery led to further complications, according to the complaint, but she had to turn the case over to Anderson because she was leaving for vacation.

Anderson, of Wyoming Surgical Associates, operated on Poche on Aug. 6, but he should have known the patient's needs were beyond the expertise of himself and the hospital, the complaint states. Instead of transferring Poche to another hospital, Anderson performed five more surgeries, according to the complaint.

Because of the lack of progress, Cynthia Poche persuaded Anderson to transfer her husband to the Bethesda Naval Hospital in Maryland, according to the complaint.

She was a hero because of her insistence, Shapiro said. She also left her 13-week-old newborn to the care of others in Georgia while she attended the trial in Cheyenne, he said.

Cynthia Poche said she had to do it even though few medical malpractice lawsuits that go to trial are decided in favor of people like her. "You just know in your gut something's wrong, and this was very wrong."

Edward Poche, Shapiro said, did not remember anything from the time he entered the Wyoming Medical Center to his recovery in Maryland, did not see his other child for more than eight months, has had his stomach half-reconstructed with a special mesh, and is restricted in his movements - no bending, twisting or lifting anything over 10 pounds - so he can no longer work as a diesel mechanic. The Army discharged him last week.

Damages

The damages awarded by the jury cannot restore Poche's life to its former quality, but it will give his family a start and hopefully serve as an inspiration to those who believe they've been harmed by medical malpractice, he said.

According to the clerk of U.S. District Court, the jury awarded Edward Poche $165,000 for future medical expenses; $400,000 for future lost earnings; $50,000 for past and future household services; $375,000 for pain and suffering; $250,000 for lost of enjoyment of life; and $250,000 for disfigurement and disability.

The jury awarded Cynthia Poche $100,000 for loss of consortium - company, help and affection - with her husband.

It also awarded the federal government $380,000 to compensate for the care the military provided Edward Poche. Assistant U.S. Attorney Steven Sharpe was out of his office and could not be reached for comment.

All things considered, Poche said he's doing well and facing the realization that he will need to go to school to learn a new trade.

While his Army career is over, it taught him a lesson that helped him through his ordeal, he said. "Being a military man, when I start something I finish it."

Reach Tom Morton at (307) 266-0592, or at tom.morton@trib.com. Read his blog at tribtown.trib.com/TomMorton/blog.

Last we knew: A soldier, his wife and the federal government sought about $4.6 million for damages in a federal civil lawsuit from three Casper doctors for medical malpractice.

The latest: After a four-week trial, the jury awarded $1.6 million to the couple for the actions of two of the doctors, and awarded the federal government $380,000.

What's next: Former U.S. Army Staff Sgt. Edward Poche is looking for a job. One doctor's attorney is considering appealing the case.

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