Use stem cells, get sued

Dimitri Bonnville got cardiac stem cell therapy. Now he's suing

May 9, 2005
Adam Marcus

When Dimitri Bonnville of Almont, Michigan, was shot in the chest with a nail gun by a construction coworker two years ago, the then 16-year-old eventually wound up at William Beaumont Hospital in Royal Oak, where James Robbins, a trauma surgeon, removed the three-inch-long spike from his right ventricle.

The procedure worked-at first. But the teenager soon suffered a major heart attack, prompting Beaumont physicians to suggest a radical-and, some say, unwarranted-step: They offered the boy an experimental stem cell transplant to rejuvenate his dead myocardium. Bonnville and his parents agreed, and he soon became the first cardiac stem cell recipient in the United States-a feat William Beaumont trumpeted in press releases that featured Bonnville and his family as willing participants.

Evidently, they've had a change of, er, heart. Earlier this year, the Bonnvilles filed suit against William Beaumont Hospital, Robbins, and Srinivas Dukkipati, the cardiology fellow who saw Bonnville after surgery. The youth-his father, Craig, is also party to the lawsuit-claims in a lengthy list of charges that it was the negligence of his initial care, and not the severity of his heart injury, that made the stem cell transplant necessary.

Officials for William Beaumont decline to discuss the case. In a prepared statement, however, the hospital said: "We're surprised and disappointed that the Bonnville family would file a lawsuit. We saved Dimitri's life by giving him the most advanced heart treatment available anywhere. When our physicians last saw Dimitri three months after treatment, he was doing well and was showing signs of improved heart function." One of the two surgeons, Dukkipati, now at Massachusetts General Hospital in Boston, told The Scientist he could not discuss the case. The family is not suing Steven Timmis, who performed the stem cell treatment, although he is named in the suit.

Dimitri Bonnville's stepmother Tami told The Scientist that Dimitri has lost "a little over a third" of his heart function, and that the family is "just taking it one day at a time." She said lawyers had advised her not to talk about the case. Milton Greenman, the lead lawyer for the Bonnville family, says Dimitri now has the heart "of a 75-year-old" and needs a heart transplant. That would not be the case, Greenman says, had Beaumont doctors done a better job. As for the stem cell transplant: "Expenses were incurred, invasion to his body was also incurred. That shouldn't have taken place had the earlier negligence not occurred."

Greenman, who won a $1.5 million award in a previous suit against Beaumont and last year filed another suit against the hospital-both operations, for kidney transplants, were performed by the same surgeon, Steven Cohn-says he believes the hospital is a "fine institution" and one of the most technologically advanced in the state. The hospital had not performed any cardiac stem cell transplants before Bonnville's, and hasn't done any since, following an order from the Food and Drug Administration.

"In this case, however, they made glaring errors," says Greenman. What's more, the lawyer says, he considers the stem cell transplant an act of "fraud" and will argue in court, should the case get that far, that the hospital oversold the experimental procedure to a desperate patient. Beaumont, he claims, suggested that the heart cell graft was proven by clinical studies when it in fact had not been. Dimitri Bonnville "was the study," he says. Greenman would not disclose a dollar amount for the damages the Bonnvilles are seeking.

Roberto Bolli, chief of cardiology at the University of Louisville, says his hospital never would have allowed an experimental transplant in a single patient outside the auspice of a clinical trial. "This case is something that in my opinion should not have been done," Bolli says. "It should be done as part of a research protocol."

Bolli says the United States is "light years" behind Europe in the field of cardiac stem cells; a lag he blames on an overburdensome regulatory process that makes conducting clinical trials "incredibly difficult. The paperwork you have to go through is mind boggling," says Bolli, whose group is currently awaiting an okay from the FDA on a trial application for heart grafts.

There's one more reason Bolli believes the United States is trailing in the stem cell race: "Too many lawyers."