A Mercer County jury Friday awarded a Hermitage couple $12.8 million -- the largest ever awarded in the county -- in a malpractice case against a pair of doctors and Sharon Regional Health System.

Marie Anne and Joseph L. Viola, 320 Robertson Road, in May 1999 sued Dr. John P. Gallagher of Shenango Valley Obstetrics/Gynecology Associates, and Dr. John C. Garriott of Holt, Allen and Garriott Radiology Associates.

The Violas’ suit claims Gallagher failed to "timely and properly" evaluate and treat Mrs. Viola for breast cancer and that Garriott did not notice a lesion on Mrs. Viola’s 1996 mammogram.

The lawsuit also states that if the lesion had been recognized on the 1996 mammogram and appropriately treated, Mrs. Viola’s cancer would not have spread.

According to court reports from the nine-day trial:

Mrs. Viola, then 40, went to Gallagher for an annual gynecological examination on Aug. 9, 1994. Because of her age and a family history of breast cancer, Gallagher referred her for a mammogram on Aug. 24, 1994, at Sharon Regional.

Garriott found Mrs. Viola’s mammogram normal. When Garriott reported the finding to Gallagher, he suggested Mrs. Viola return for a follow-up screening in 12 months.

Gallagher did not inform Mrs. Viola of Garriott’s recommendation, the lawsuit says, although a pretrial statement filed on Gallagher’s behalf, states Mrs. Viola was asked to return in one year.

The court report continues:

On Sept. 20, 1996, Mrs. Viola went to Gallagher with complaints of a lump and tenderness and pain in her left breast. She also told him her mother had recently been diagnosed with breast cancer. Gallagher examined Mrs. Viola’s left breast and told her he felt only "fibrocystic vague changes" that were not significant.

Gallagher told Mrs. Viola her family history should not be a concern to her and that she could return for a follow-up exam in two years. He also ordered Mrs. Viola to undergo another mammogram.

Mrs. Viola underwent a mammogram Oct. 4, 1996, at Sharon Regional. Again, Garriott reviewed the mammogram and reported it showed only dense breast tissue and that it was unchanged from Mrs. Viola’s 1994 screening. Garriott reported his findings to Gallagher.

A pretrial statement filed on behalf of Garriott states Mrs. Viola did not complain of a lump, but she did complain of breast pain that had gone away when she went for the 1996 mammogram. Garriott’s impression was there had been no changes since the last mammogram, the statement says.

Also, according to the lawsuit:

In December 1997, Mrs. Viola began experiencing severe lower back pain. Treatments with medication and physical therapy were unsuccessful, so on May 27, 1998, Mrs. Viola’s family physician ordered her to undergo an MRI scan of her lower spine. The Magnetic Resonance Image revealed a lesion there.

After finding the lesion, Mrs. Viola’s family physician examined her and found the lump in her left breast that she had reported to Gallagher in 1996. Mrs. Viola underwent another mammogram, which revealed a lesion in her left breast; a biopsy of that lesion revealed an aggressive advanced stage breast cancer that had spread to the bone. A biopsy of the lesion on Mrs. Viola’s spine also revealed a malignant tumor.

Due to the advanced stage of her disease, Mrs. Viola had to undergo "aggressive and disabling" chemotherapy and radiation treatment, stem-cell rescue and a bone-marrow transplant. Her most recent scanning revealed the cancer has spread to other parts of her body, including her liver. Because there is no cure for cancer as advanced as Mrs. Viola’s, her prognosis is poor and her likelihood of death is extremely high, the lawsuit said.

The jury found both Gallagher and Garriott were negligent and their negligence was a substantial factor in Mrs. Viola’s advanced cancer.

The jury found that Sharon Regional was responsible as an "ostensible agency" for Garriott, said Judge Michael Wherry. He explained that although Garriott is not a hospital employee, Mrs. Viola could "reasonably assume" he was because she went to the hospital for the mammogram.

Asked to assign a percentage of negligence in the case, the jury found Garriott and the hospital jointly 72 percent negligent and Gallagher, 28 percent responsible.

Mrs. Viola was awarded $344,000 for medical expenses, $1.5 million for lost earnings, $4 million for pain and suffering, $1.5 million for embarrassment and humiliation and $500,000 for loss of enjoyment of life. Her husband was awarded $500,000 for loss of companionship, according to court documents.

The Violas did not return phone calls to The Herald on Friday. Gallagher and Garriott were unavailable for comment.

A statement from Sharon Regional expressed "sincere sympathy" to Mrs. Viola and her family. It also said the verdict did not "reflect any wrongdoing or negligence on the part of Sharon Regional or any of our employees."