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“You Should Kick My A**,” Doctor Says in Med Mal Case

May 2, 2024

A surgeon in Kentucky allegedly told a patient’s family. “Kick my a**, I deserve it” after complications led to severe blood loss.

Dr. Oon Leedhanachoke made that statement or words to that effect after a 2015 lumpectomy that resulted in neurological issues for the patient, Christine Smith. A wire used for a chemotherapy port placement pierced her superior vena cava and caused her to lose a significant amount of blood. Several months later, she started to have neurological deficits. Smith sued Leedhanachoke for negligence.


Smith was diagnosed with breast cancer, and Dr. Leedhanachoke performed a successful lumpectomy on her at Pikeville Medical Center. The surgeon also twice tried to surgically place a chemotherapy port into Smith’s superior vena cava. However, during surgery, her blood pressure became undetectable, and her oxygen levels declined. Apparently, the wire used for the port placement pierced Smith’s vein and caused her to lose a high volume of blood. Dr. Leedhanachoke consulted a cardiologist, and they were able to stabilize Smith.

Smith awoke post-op with no apparent cognitive defects. Afterward, she underwent chemotherapy treatments for her breast cancer. About four months later, she began to experience neurological deficits.

Smith sued Dr. Leedhanachoke, alleging that his negligence during the port placement surgery was the cause of her later neurological problems.

Is the “Kick My A**” Comment Admissible at Trial?

Smith’s husband, their two children, and a friend were at the hospital during her surgery and recovery. They were also there when Leedhanachoke apologized for the complications and results of the port placement surgery. In the personal injury litigation, they testified about this. Smith’s husband said the surgeon told him to “kick my a**, I deserve it.” The Smith’s children and the friend testified to a similar statement from Leedhanachoke.

Dr. Leedhanachoke filed a motion to prevent evidence concerning the alleged statement from being introduced to the jury because of its prejudicial nature. The trial court agreed and excluded any mention of Dr. Leedhanachoke’s “alleged comment about kicking his ‘rear end[.]'”

The trial lasted nine days, and multiple witnesses testified. During opening statements, counsel for the Smiths told the jurors they would hear witness testimony that Leedhanachoke was terribly upset after the operation, admitted he made a mistake, and said “Hit me, hit me, hit me.”

The surgeon testified that he was “devastated” about the surgery but added he adhered to the standard of care and that the placement of the port looked normal on an x-ray.

The jury ruled against the Smiths, and after the denial of their motion for a new trial, they appealed.

The Court of Appeals Affirms

The Court held that the statement was more prejudicial than probative.
“Even without this statement, the jury heard how upset Dr. Leedhanachoke appeared to be after the surgery, and that the family believed he was trying to apologize to them about its outcome,” Chief Judge Alison Jones wrote. “This was sufficient for the jury to conclude that Dr. Leedhanachoke blamed himself for how the surgery turned out, and to create an inference that Dr. Leedhanachoke may have done something wrong to cause that outcome.”

The Court of Appeals found that the doctor’s exact statement was that someone should “kick his a**,” and although colorful, it wouldn’t have appreciably strengthened this inference.

Even though relevant and otherwise admissible, evidence may be excluded if “its probative value is substantially outweighed by the danger of undue prejudice, confusion of the issues, or misleading the jury, or by considerations of undue delay, or needless presentation of cumulative evidence,” Judge Jones opined, quoting Kentucky Rule of Evidence 403.

Ultimately, the trial court allowed a significant amount of testimony into the record concerning Leedhanachoke’s statements and demeanor after the surgery. The only major statement that the trial court disallowed was that Dr. Leedhanachoke indicated that Smith’s husband should “kick his a**” for how the surgery turned out and some of his exact mannerisms. Even without this statement, the jury heard how upset the surgeon appeared to be after the surgery, and that the family believed that he was trying to apologize to them about its outcome. The Court of Appeals said that this was enough for the jury to conclude that the surgeon blamed himself for how the surgery turned out, and to create an inference that Dr. Leedhanachoke may have done something wrong to cause that outcome.

As a result, the trial court decision was affirmed, and there was no abuse of discretion.

Leedhanachoke is a general surgeon in Pikeville, Kentucky, and is affiliated with Pikeville Medical Center. He received his medical degree from Mahidol University Faculty of Medicine and has been in practice for more than 20 years. His specialties are treating colonoscopy, upper GI endoscopy, and surgical removal of the colon.

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