Almost as soon as he woke up from surgery, Randy Dalo began to sense that something was wrong.
He was in a lot of pain, more than he had expected. And, even worse, he told his wife Karen about a disturbing dream he had had. He saw three or four misty shadows of people looming above him, then a bright light, and when he tried to scream, he couldn’t. That’s when he woke up.
The dream was so vivid that Dalo thought it was actually a memory – that he had woken up during the operation. But Karen dismissed that idea. A longtime nurse at UC San Diego Medical Center in Hillcrest who had worked in operating rooms for most of her career, she had selected the surgical team that operated on her husband in January 2017.
All but one. On the morning of the operation, the anesthesiologist chosen by Dalo was not available. Instead, the work would be managed by Dr. Bradley Hay.
For the Dalos, this would be a significant change. Almost six years later, Dalo still suffers from a recurring nightmare of waking up in surgery.
In January, a lawsuit filed by the Dalos is set to go to trial in a Superior Court courtroom in downtown San Diego. It targets Hay, who relinquished his medical license in 2018, former head of the anesthesiology department Dr. Gerard Manecke Jr., anesthesiology nurse Tammy Nodler and the University of California Regents.
Dalo maintains that he did not receive enough anesthesia for the operation, which caused him to wake up. He also claims that Hay and the nurse then falsified official medical records to make it look like he had received enough.
The lawsuit also blames UCSD for covering up the startling scene that occurred after the surgery.
Hay was found in a hospital bathroom, unconscious, face down, his pants around his ankles and covered in vomit. Around him were three syringes, two of which contained sufentanil – a strong opioid that a later investigation by the state medical board found Hay had stolen fentanyl from the hospital for years.
He injected powerful drugs up to eight times a day, according to court records for the prosecution.
The couple say UCSD officials were evasive for months and did not fully disclose what happened. They also said that although the hospital knew that Hay had a substance abuse problem and was stealing fentanyl from the hospital as early as 2003, they never disclosed this fact to any patient.
This could pose a major problem, said Eugene Iredale, the couple’s attorney. He said UCSD’s own information showed that in 2016 and 2017, Hay, who had been off drugs for several years, became addicted to fentanyl again and treated 800 patients during that time.
The identities of those patients have not been released by UCSD, Iredale said.
Hay’s attorney did not return email and phone messages seeking comment on the lawsuit. Hay gave a lengthy deposition in 2019 detailing his addiction issues that will be part of the upcoming trial.
In court papers, lawyers representing the hospital, Manecke and Nodler argued that UCSD’s own expert said the amount of anesthesia Hay administered to Dalo was “within the standard of care” and that, therefore, the hospital could not be considered negligent.
Furthermore, UCSD contends that the actions of Nodler and Manecke “in no way contributed to the injuries” Dalo said he suffered after the operation.
In an emailed statement, Jacqueline Carr, executive director of communications for UC San Diego Health Sciences, said the university could not comment on details of an ongoing case, but said security was a “core value” in the hospital.
“We are deeply sorry that a former member of our team violated hospital policies and standards, our trust and the trust of his patients and colleagues,” the statement read. The statement said former Hay patients who may have questions about their care can contact UCSD at (858) 249-2800.
Dalo required surgery after years of riding the waves of the Pacific as a captain of sport fishing boats out of San Diego, which took a toll on him. The January 2017 operation involved his neck, the first of two planned operations that would help him.
After the operation, he continued to interrogate his wife to find out if he had woken up during the operation or if something had happened. But for months, according to court records, she brushed off his concerns, telling him she had personally selected the team so he would receive the best care.
The disagreement strained their marriage. “My wife didn’t believe me,” Dalo said in an interview. So he stopped asking questions and withdrew. However, the nightmares continued.
Hay’s story was unknown to the couple. Medical board trial and procedural records indicate that he began using fentanyl in 2003, while a resident at UCSD. He stole the highly addictive drug from the hospital and injected it into the bathrooms.
He joined the hospital staff in 2007, but in 2008 – after colleagues saw him under the influence of alcohol while on duty – he was referred to the welfare committee of the hospital. He underwent three months of treatment and joined the staff in November 2008.
He remained sober until 2014, according to Medical Board procedures. But in April 2016, he started stealing and using fentanyl again. In a 2019 deposition, Hay said he used the drug five to eight times a day in the hospital.
During this time, the hospital made him a member of the welfare committee, he testified, which was responsible for helping other hospital employees with substance abuse issues.
According to the lawsuit, Hay stole the drugs by obtaining a certain amount of fentanyl from the pharmacy and only using a portion on the patient. He would falsify the medical record to show that everything was used on the patient and take the unused part for himself.
In Dalo’s case, Iredale argues that Hay did not give him enough medication to keep him unconscious, withholding some of the medication for his own use. Medical records showing how much and when the anesthetic was administered were tampered with, Hay testified in his deposition, according to a motion drafted by Iredale opposing UCSD’s efforts to dismiss the case.
However, Nodler, the anesthesiology nurse during the operation, says no records were changed, the motion states.
In the months after the operation, Karen Dalo said she asked Nodler and Manecke if anything happened during the operation. Three weeks after the operation, Nodler told her that Hay had a “breakdown” after the operation, but that everything was fine with her husband.
She also said Manecke repeatedly told her that everything went well with the operation, according to court records. It wasn’t until November – 11 months later – when Karen Dalo read a story about Hay’s license being suspended by the state medical board because he was found passed out in the bathroom that she realized that her husband was not lying to her.
She said she was angry with some of the people she worked for and that Hay’s addiction issues were not disclosed. “And the guilt too,” she said in an interview. “For not believing my husband.”
Iredale said UCSD has failed both a patient and a longtime employee. “They just resisted acknowledging that what happened was wrong and took responsibility for it,” he said.
Randy Dalo said he wanted UCSD to be held accountable for what happened. He sees a therapist for his recurring dream of waking up. And, he has yet to have the second surgery he needs.
California Daily Newspapers