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    Bowel perforation following salpingectomy

     

    Excessive cauterization blamed for fistula

    Facts

    AN ILLINOIS WOMAN underwent a supracervical hysterectomy with bilateral salpingo-oophorectomy performed by her gynecologist in 2007. The patient, age 52, filed a malpractice case and claimed that the physician used electrocauterization excessively during the procedure, leading to a vaginal-peritoneal fistula. She developed an abscess, prolonged infection, pain, and had two additional operations a few months later. The woman also claimed that Seprafilm, an adhesion barrier, was used improperly, preventing the fistula from healing. She also argued that she would not have had her ovaries removed if she had known the consequence of doing so would include hot flashes and painful sexual intercourse.

    The gynecologist claimed that the operation was properly performed and that there was no evidence that excessive electrocautery was used. She maintained that the patient’s consent was obtained to remove her ovaries and the Seprafilm was properly used and did not cause any injury.

    The verdict

    A defense verdict was returned.

    Claim of delayed diagnosis of cervical cancer

    Facts

    A GYNECOLOGIST PERFORMED a pelvic exam and Pap smear on a 50-year-old New York woman in 2005. The pathology report revealed dysplasia of the epithelial cells of the endocervical canal. Another test revealed that the patient had subtypes of human papillomavirus (HPV).

    Her physician recommended a colposcopy, which was performed 2 months after the initial exam. A biopsy revealed a precancerous lesion. The physician recommended cryosurgery, which was performed 2 months later. A followup test did not reveal subtypes of HPV, but the report did show cervical dysplasia. Six months later, an additional cryosurgery was performed, and another follow-up test again did not reveal HPV, but it was detected 6 months later. Surgery revealed severe squamous epithelial dysplasia. The patient went to another physician, who subsequently diagnosed stage III squamous cell carcinoma of the cervix. The patient then underwent a laparotomy, hysterectomy, removal of the upper portion of the vagina, and a salpingo-oophorectomy, approximately 1 year and 8 months after the 2005 examination. The procedures eradicated her cancer.

    The woman sued the original gynecologist and claimed that he failed to properly address the dysplasia found in 2005. The patient claimed that her dysplasia was in areas that could not be reached by cryosurgery and that conization should have been performed, which would have completely eradicated the precancerous tissue.

    The physician argued that cryosurgery was appropriate, all follow up was properly managed, and that cancer is a rare result of dysplasia.

    The verdict

    A defense verdict was returned.

     

    Dawn Collins, JD
    MS COLLINS is an attorney specializing in medical malpractice in Long Beach, California. She welcomes feedback on this column via ...

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