The deputy bled profusely in the operating room, but as he was losing blood, additional blood products and fluid were pumped in. In all, he lost an estimated 10 liters, or almost twice his total blood supply.
By the end of surgery, records indicate, he received far more blood and fluid than he lost. His hands, face, legs and scrotum were grossly swollen, and a chest X-ray showed fluid in the lungs, according to notes in the patient file.
"Because of the fear of over-transfusion," about 1.5 liters of blood were drained from the deputy shortly after surgery, emergency medicine chief Dr. William C. Shoemaker said in a memo reviewing the case for Haughton in April, 1992.
In addition, multiple doses of highly concentrated albumin were given and a powerful diuretic Lasix was administered to drain off excess fluid, records show.
Nevertheless, his blood pressure and oxygen consumption dropped precipitously. About noon on March 31, the cardiac drugs verapamil and labetalol were administered. "The patient went into cardiopulmonary arrest from which he could not be resuscitated," the memo states.
When contacted by telephone and asked about the memo, Shoemaker hung up, saying: "I don't know what you're talking about and I have no comment to make."
Dr. Jake Davis, an anesthesiologist who treated Yamamoto, also refused to be interviewed about the case and hung up.
An autopsy found that Yamamoto's body was overloaded with fluid and that he died of "adult respiratory distress syndrome." Instead of being full of air, the lungs oozed fluid. In the space between each lung and the chest wall, which is supposed to be virtually empty, there was almost a quart of fluid, the coroner found.
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Haughton said that experts have evaluated "all facets" of the medical care Yamamoto received and determined it was within acceptable medical bounds. "I have no idea what is driving this case," he said. "It puzzles me."
Dr. Reed Tuckson, president of the Charles R. Drew School of Medicine and Science, whose faculty serves as King's senior physicians, declined to comment on the Yamamoto investigation. But he said: "I really am unhappy when people continue to try to put the hospital in a bad light. There are so many dedicated people doing work that nobody else wants to do."
