DATE: Wednesday, September 10, 1997         TAG: 9709100548

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 

SOURCE: BY MARC DAVIS, STAFF WRITER 

DATELINE: NORFOLK                           LENGTH:  102 lines

JURY RULES AGAINST MAN WHO CUT OFF HIS HAND JURY DECIDES MAN BORE RESPONSIBILITY WHEN HE REFUSED TO ALLOW RE-ATTACHMENT.

A jury ruled Tuesday that a doctor acted properly when he followed the wishes of a patient who intentionally cut off his own hand with a power saw and insisted it not be reattached.

The patient, Thomas W. Passmore, 33, said he hallucinated a ``666'' on the hand and thought it was possessed by the devil when he cut it off at a construction site where he was working.

He claimed in court that he was psychotic during the 1994 incident and therefore incompetent to make his own medical decisions. Passmore sued the surgeon, Dr. Tad E. Grenga of Portsmouth, for $3 million.

In a six-day trial, Passmore's attorney argued that Grenga should have known Passmore was mentally ill and should have gotten a court order to reattach the hand.

The doctor's attorney, however, argued that Passmore was sane and competent to reject surgery in the hours after the incident.

The jury deliberated just 30 minutes before ruling for the doctor.

One juror, 73-year-old Carol Proctor, hugged the doctor in the hallway outside the courtroom after the trial. ``I'm so glad you won!'' she told him.

Proctor, a nursery worker, said she was unimpressed by Passmore.

``The boy, he knew what he was doing when he cut his hand off. It made me so mad. He acts like he wants free money,'' Proctor said in an interview after the verdict. ``The doctor tried to help him. I felt he did all he could for that man. He's a good doctor, as far as I'm concerned. . . . I felt very sorry for the doctor more than I did for this man.''

Other jurors declined to comment as they left the courthouse.

After the trial, Grenga dashed from the courthouse to Sentara Norfolk General Hospital to make his rounds. ``I have got to get back to seeing my patients and get back to work,'' he said.

Passmore had no comment. His attorney, Robert E. Brown, said he does not plan to appeal.

It was one of the oddest cases to come through Norfolk Circuit Court in years.

Passmore was 30 years old, recently unemployed and homeless when the incident happened. He had a history of alcoholism and bipolar disorder, also known as manic-depression, and had been kicked out of his father's house in Nags Head just days before.

Passmore had started and stopped several alcohol treatment programs in the years before, and had stopped taking his anti-psychotic medication a year earlier.

But Passmore also sought help just before the incident. He visited a mental- health clinic on the Outer Banks and had an appointment to see a doctor three days later.

Passmore, trained as a computer programmer, was working temporarily at a construction site at Kill Devil Hills when he cut off his right hand. He hallucinated seeing a ``666'' on the hand and cut it cleanly with a table saw.

Horrified workers immediately packed the hand in ice, put a tourniquet on Passmore's arm to stop the bleeding and called 911. Passmore was flown by helicopter to Norfolk General.

There, Grenga scheduled hand-reattachment surgery. At first, Passmore agreed to it and signed a consent form. But two hours later, just before the surgery was to start, Passmore refused to let the doctor proceed.

Passmore did not tell the doctor why he refused but said he would cut it off again if Grenga reattached it. He testified that he thought the hand was evil and that he would go to hell if it were reattached.

Not sure what to do, Grenga consulted the hospital's psychiatric department. Earlier, a psychiatric resident had declared Grenga competent to agree to the surgery.

Grenga then called Norfolk Circuit Court Judge William F. Rutherford. The judge advised Grenga that if Passmore was indeed competent, and if Grenga reattached the hand against the patient's wishes, the doctor might be guilty of assault.

Grenga then decided not to reattach the hand. He closed the wound instead.

Passmore filed suit last year. He initially sued Grenga, the hospital, a psychiatrist and two psychiatric residents. He dropped the case against the residents before trial and settled the case against the psychiatrist for an unknown amount of money.

The hospital was dropped as a defendant in mid-trial when the judge disqualified Passmore's expert witness against the hospital.

In closing arguments Tuesday, Passmore's attorney said Grenga is not ``an evil person'' or an incompetent surgeon.

``But he must take responsibility for his errors,'' Brown said. ``And he made a tremendous, fundamental error in saying that Thomas Passmore had the mental competence and capacity to make an informed medical decision.''

Brown warned the jury, ``This case is about a number of things. . . . What it is not about is that Thomas Passmore cut off his own hand. The fact that Thomas Passmore cut off his own hand has no bearing on the obligations of Tad Grenga.''

Grenga's attorney, John Fitzpatrick, told jurors that the case ``is about personal responsibility.''

``Mr. Brown doesn't get the message,'' Fitzpatrick said. ``Dr. Grenga is not saying in any way that because he (Passmore) cut it off himself he's not entitled to care. . . . The issue is that that man (Passmore) made the decision not to reattach. He made it, and nobody else.'' ILLUSTRATION: Thomas W. Passmore claimed he was psychotic when he

cut his hand off in 1994.

ALBA BRAGOLI/Illustration

Thomas W. Passmore, foreground, refused surgery by Dr. Tad E.

Grenga, on stand, to re-attach his hand. Grenga consulted a

psychiatric resident and a Circuit Court judge before deciding

against the surgery. KEYWORDS: TRIAL LAWSUIT VERDICT

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