A doctor who has been an outspoken advocate for caps on medical malpractice awards was found negligent for a failed hip replacement and ordered by a jury to pay $800,000 in damages.

An Allegheny County Common Pleas Court jury earlier this month said Dr. Gerald Pifer, an Allegheny General Hospital orthopedic surgeon, was negligent in replacing Ella Jean Shannon's hip in August 2000.

Shannon, 68, of the West End, said Pifer cracked her femur while performing the surgery at AGH using a technique in which the surgeon tamps the prosthetic device into the bone.

Shannon, the widow of a steelworker who lives on a pension and Social Security, later needed a second surgery by another doctor to fix the damage, said her lawyer, Henry Wallace.

Pifer, the immediate past president of the Allegheny County Medical Society, didn't return a message yesterday, nor did his lawyer, John Heisey.

Pifer has consistently lobbied for malpractice insurance reform, saying high premiums for insurance coverage are driving doctors out of Pennsylvania. He has maintained that patients who are injured should be able to sue, but that damages in civil cases need to be limited, as they are in some states.

"Physicians want to care for their patients, and never want to injure them," he wrote in the Post-Gazette in 2002. "But there is a difference between negligence and a bad outcome, and a judgment call that, in retrospect, was the wrong choice."

In the Shannon case, the jury awarded her nothing in medical bills but $800,000 in damages for "past and future pain and suffering, embarrassment and humiliation" and "loss of enjoyment of life."

Shannon, who weighs 250 pounds, had her right hip replaced by another doctor at AGH in 1997 and then needed her left hip done, too. But the doctor who did the first procedure had left the hospital, so she saw his ex-partner, Pifer.

Wallace said Pifer had a resident working with him, Thomas Hughes, and that during the trial neither could remember who did the actual surgery.

He said Pifer didn't tell Shannon the resident would be there, nor did he explain the nature of the operation. Some hip replacements are done with cement and some aren't, depending on the patient's condition. Wallace said Pifer didn't tell Shannon anything about the procedure or its risks.

Part of the jury's instructions included answering whether Shannon had received "informed consent" before the operation. The jury said no.

During the operation, Shannon's femur cracked as Pifer drove in the prosthetic, and the doctor wired the bone back together.

Some time after the procedure, Shannon was recovering at home when her hip gave way.

Experts on both sides presented opinions on whether Pifer was to blame.

Dr. Lawrence S. Crossett, a joint reconstructionist at UPMC Shadyside, said the failure of the hip was "clearly related" to a post-operative infection, not a "breach in the standard of care." He said cracked femurs sometimes occur during hip replacements and that Pifer handled this one correctly.

But Dr. Gregory Shankman, an orthopedic surgeon in Utica, N.Y., said Pifer used a prosthetic that was too big and drove it in at the wrong angle. He also said Pifer didn't use enough wire to repair the fracture and didn't use any cement to make sure the prosthetic fit correctly.

This isn't the first time Pifer has been ordered to pay a large jury award. In 1994, a jury awarded $800,000 to the widow of a Moon man who died after being treated for injuries in an industrial accident. The jury ruled against Pifer and another surgeon.