Medicolegal Issues

Malpractice Chronicle


 

At this appointment, the family clinician was concerned about the woman’s respiratory status and instructed her to return to the ED. She was readmitted and underwent an exploratory laparotomy, appendectomy, lysis of adhesions, drainage of a pelvic abscess, and a right oophorectomy. It was extremely difficult to wean the patient from the ventilator after surgery, which necessitated treatment at an extended-stay facility until early July. She was then referred to a rehabilitation center for more than one month. As of the date of trial, she remained dependent on supplemental oxygen.

The plaintiff claimed that Dr. B. was negligent for failing to order additional abdominal scans before the patient’s initial discharge as well as for not continuing IV antibiotics, not performing a needle aspiration of a suspected tubo-ovarian abscess, and not removing the diseased ovary surgically. Further, the patient claimed that she had been discharged improperly.

The defendant argued that the plaintiff’s obesity, her pulmonary problems, and her cigarette smoking convinced the physicians that surgery should not be performed without giving medical treatment a chance to work.

A defense verdict was returned.

Colon Perforated During Surgery for Endometriosis
After a miscarriage attributed to endometriosis, a 35-year-old woman was treated by the defendant Ob-Gyn, Dr. V., at the defendant women’s health center. Dr. V. performed an exploratory laparoscopy to remove the endometriotic lesions. The patient was discharged but returned later that day with symptoms of peritonitis.

During an open exploratory emergency surgery, a perforation was discovered and the bowel was repaired. The surgery included placement of a colostomy bag, which was reversed five months later. The patient required an extended recovery, which included an ICU stay for treatment of peritonitis, development of intestinal problems due to scar tissue, recurrence and worsening of preexisting irritable bowel syndrome, and development of a hernia at the surgical site, which required additional surgery and scar revision one year later. She continued to have intestinal problems.

It was during the initial laparoscopic surgery, the plaintiff claimed, that her large bowel was perforated, and the perforation went unnoticed—both due to negligence.

The defendant contended that the endometrial nodule was some distance from the bowel and that a small portion of the bowel was bound up in the scarring but was not visible in the operative field. The defendant also claimed that the plaintiff’s intestinal complications following the colostomy reversal were due to preexisting irritable bowel syndrome and were not related to the bowel perforation. Finally, the defendant argued that perforation was a known risk of the surgery.

A verdict of $717,871 was returned.

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