HAMMOND — Opening arguments were given Tuesday in the civil trial of a Munster cardiologist accused of implanting a unnecessary cardiac device in a man's heart.
Dr. Arvind Gandhi, who retired in 2014, stands accused by hundreds of patients of doing unnecessary cardiac procedures.
After a day and a half of jury selection, both sides outlined their cases before the eight-person jury in Lake County Superior Court in Hammond.
Ray Kammer, formerly of Hammond and now living in Ohio, sued Gandhi, claiming the cardiac defibrillator the doctor implanted in 2007 was unnecessary. He is seeking $3 million for pain and suffering.
Kammer is also suing Gandhi's former practice, Cardiology Associates of Northwest Indiana, and the hospital where the procedure was performed, Community Hospital in Munster. Gandhi, the practice and the hospital all deny Kammer's claims.
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In June 2007, Kammer, then 25, presented to the emergency room at Community Hospital with signs of heart failure and kidney problems and dangerously high blood pressure.
He claims Gandhi told him he was at risk of dying if he didn't have a defibrillator implanted immediately.
Kammer sought a second opinion, from Dr. Raghuram Dasari, a Munster electrophysiologist, who told him he should take medication and be re-evaluated in 90 days, guidelines recommended by the Heart Rhythm Society, electrophysiologists' national organization. Dasari told Kammer that his risk of sudden death was approximately 1 percent.
The medication reduced Kammer's blood pressure, helped his breathing and stopped swelling in his extremities, said his attorney, Bobby DiCello.
Still, "He can't stop thinking about what Dr. Gandhi told him," DiCello said. "In the end, fear wins out."
Kammer had the device implanted by Gandhi that same month.
In Kammer's medical records, Gandhi indicated why he believed the surgery was needed: that Kammer had coronary artery disease, a sustained fast heart beat and an electrophysiology study, none of which Kammer had, his attorneys argue. They also say Gandhi gave incorrect readings for Kammer's heart rhythm and level of heart failure.
"Ray didn't have these problems on the day he went into surgery," DiCello said, stating that Gandhi testified during a deposition that "this was a documentation error."
In the fall of that year, Kammer read an article in The Times about how the defibrillator leads used on his heart had been declared defective and recalled before his surgery.
Kammer filed a medical malpractice complaint against Gandhi. An independent, three-member state medical review panel unanimously ruled that Gandhi and his practice had performed an "unnecessary procedure" that carried "risks of removal" and "risk of retention."
"Ray is devastated. He is in utter shock," DiCello said.
In 2014, when the battery started dying, Kammer had to undergo another procedure to replace it. His lawyer said he will need the battery replaced every seven years, for a device he didn't need in the first place.
"Ray is in for a lifetime of unnecessary and unjust anxiety and hardship," DiCello said.
Gandhi's defense attorney, James Hough, argued that Kammer was in such poor health that a defibrillator was needed.
"A 25-year-old generally shouldn't have blood pressure so dangerously high that he ends up in the hospital. ... A 25-year-old shouldn't get short of breath just from walking," Hough said.
"Twenty-five year olds aren't supposed to have hearts so weak they get fluid buildup in the feet so severe they can hardly put on their shoes. ... (They) aren't supposed to be dangerously obese. ... (They) aren't supposed to have congestive heart failure."
"This is the situation Ray Kammer had when he enters the hospital in June 2007," Hough said. In the ER, Kammer's blood pressure was 178 over 122. and an echocardiogram showed his heart was pumping blood at roughly half the normal rate. "Now he's at risk for sudden cardiac death," Hough said.
"The safest thing for Ray Kammer ... was to give him the defibrillator .. the ability to restart that sick heart if it stops on him," Hough said.
He said Gandhi was also concerned Kammer wouldn't take his medications, as he had earlier not followed his doctor's orders after being diagnosed with high blood pressure.
Hough pointed out that Kammer had a second opinion and "it's not as if Dr. Gandhi came to him and gave him a sales job." Kammer went back to Gandhi for the procedure. "Ray made that considered decision himself," Hough said.
Hough noted that in 2013 Kammer had the device taken out and a similar one implanted. Hough said Kammer "had the option of leaving it out" but didn't. Hough also said Kammer "let himself go" that same year, ending up in the hospital with 140 pounds of excess fluid in his body caused by his heart failure.
Gandhi simply used his medical judgment in recommending the defibrillator, his lawyer argued.
"Practicing medicine isn't like taking a recipe from a cookbook," Hough said. "You look the patient in the eye, look at the tests he had and you do the safest thing for him."
The trial continues Wednesday and is expected to last three weeks. Hundreds of similar complaints have been filed against Gandhi with the Indiana Department of Insurance but still have to be heard by the medical review panel before they can go to trial. Another trial, that of plaintiff Gloria Sargent, is scheduled to begin April 9.