Five hours later, the patient was taken to surgery for an exploratory laparotomy and colostomy to address the apparent perforated diverticulum. Her immediate postoperative course included profound hypotension with narrow-complex tachycardia. These developments, allegedly resulting from abdominal sepsis due to the delay in diagnosing the perforated diverticulum, necessitated pressors and dopamine.
Soon thereafter, the patient developed right-leg ischemia. She underwent embolectomy and thrombectomy to the right common femoral artery and the superficial femoral artery, with repair to the right profunda by use of a saphenous vein patch angioplasty. Two days later, the patient was taken to surgery for an above-knee amputation.
The plaintiff claimed that the defendant was negligent in failing to recognize early manifestations of diverticulitis and to order CT or MRl. The plaintiff also claimed that she should have been hospitalized when she requested admission.
The defendant maintained that the patient's history and the laboratory study results suggested that she had the flu or a urinary tract infection and that hospitalization was not needed. The defendant also maintained that when he called for a surgical consultation, the surgeon did not arrive for four and one-half hours.
According to a published report, a defense verdict was returned. A motion for a new trial was pending.
Surgery Continued Despite Patient's Deteriorating Condition
In 1986, the patient, then age 8, was found to be mildly mentally retarded (IQ, 59 to 70). He also had paranoid schizophrenia, causing him to hear voices in his head. The patient lived with his sister, who served as his guardian.
At age 19, the patient was scheduled to undergo surgery to correct curvature of the spine. The operation was to be performed by Dr. R., assisted by Dr. M. and by an anesthesiologist, Dr. L.
About one hour into the surgery, the patient began to manifest decreased urinary output with no known cause, but the procedure continued. About 90 minutes later, an equipment malfunction made it impossible for the medical team to monitor the patient's nerve responses and oxygen levels, but the surgery still continued.
At some point during the surgery, the patient had an unexplained blood loss and his serum calcium level dropped below normal. He also experienced a loss of oxygen to the brain, then went into cardiac arrest. At that point, the surgery was discontinued, uncompleted.
The patient was comatose for several days, during which he displayed prolonged seizure activity. After regaining consciousness, he remained in the hospital for nearly four weeks before being transferred to another facility for rehabilitation.
The patient continues to have symptoms of various neurologic problems, including athetoid-choreiform movement, which causes a general loss of balance and muscular control and cognitive deficits, which make him unable to communicate.
The plaintiff claimed that the surgery should have been stopped when the problems arose. The plaintiff also claimed that Dr. R. should have ordered intraoperative lab work when the plaintiff's condition deteriorated.
The matter was ultimately tried against Drs. R. and L. only. They denied any negligence.
According to a published report, a $3 million verdict was returned.