Nine years ago, 35-year-old Pamela Parker died in the hospital of Sharon Regional Health System of a blood clot in her lung, caused by complications from the Caesarean-section birth of her son three weeks earlier at a Washington County hospital.

A jury in Mercer County is hearing testimony this week in a medical malpractice case against six Washington County doctors who treated Mrs. Parker. Visiting nurses from Sharon Regional were also named in the lawsuit but have since settled the case, filed by the administrators of Mrs. Parker's estate, former Shenango Valley residents Margaret and Ronald Tonnessen. The Tonnessens, who filed the suit on behalf of Mrs. Parker's children and her mother, are seeking compensation for medical and funeral expenses plus unspecified damages.

According to Tuesday's testimony:

Mrs. Parker delivered her son Jeremy on Jan. 5, 1994, after doctors determined she had a severe case of pre-eclampsia, or swelling and high blood pressure.

After performing that surgery, doctors performed a second surgery to remove a sponge that had been left in Mrs. Parker's abdomen during the C-section.

Mrs. Parker then moved to Sharon to live with her sister to recuperate from her surgery. Visiting nurses from Sharon Regional's Home Health Agency saw Mrs. Parker each day while she was in Sharon.

On Jan. 24, Mrs. Parker was taken to the emergency room of Sharon Regional, complaining of difficulty breathing and leg pain. She was pale and her skin had a bluish tint.

Doctors diagnosed her with a pulmonary embolism, or a blood clot in her lung. She died at 2 the next morning.

Dr. Richard A. Fields, an expert witness called by the plaintiffs' attorney, John Miller, testified nurses and doctors should have made efforts to make sure Mrs. Parker did not suffer an embolism because she was a high-risk patient.

Obesity, recent surgery, a history of smoking, pain and swelling in the legs and the pre-eclampsia all made Mrs. Parker a high-risk patient, he said.

Mrs. Parker, who was 5 feet 2 inches tall, weighed 210 pounds when she died.

During his testimony, Fields said none of the home health care nurses noted they had performed tests for deep vein thrombosis, the condition that leads to blood clots in the lung, nor did they note ever asking Mrs. Parker if she was experiencing pain in her legs.

According to testimony, pieces of blood clots that form in the veins, in this case in the legs, can break off and travel through blood vessels to the lungs, which can cause immediate death.

"If there are signs of (DVT)," Fields said, "then it must be eliminated as a possibility, because it is potentially fatal."

Mrs. Parker, he said, had never been prescribed blood thinners or special pressure stockings that would promote blood flow after the surgery.

"That is common medical practice," he said.

Defense attorney Ronald Puntil, who represents the physicians named in the suit, pointed out none of the doctors or nurses had noted Mrs. Parker was having leg pain. With that in mind, he asked ifswelling alone should have clued doctors to DVT in Mrs. Parker.

"Given the fact that she was obese, a former smoker, just had surgery and superimposed with the pre-eclampsia, I would say yes.," Fields said.

Jurors also heard depositions from doctors and nurses named in the lawsuit.

Testimony continues today, with the defense's expert witness taking the stand. Arguments in the case are expected to last until at least Tuesday. The case was filed in Mercer County because Mrs. Parker died here and because the local visiting nurses were originally named in the suit.

You can e-mail Herald Staff Writer Amanda Smith-Teutsch at: ateutsch@sharonherald.com