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    Bowel perforation following salpingectomy

     

    Dawn Collins, JD

    Facts

    A NEW YORK WOMAN underwent a salpingectomy in 2009 due to an ectopic pregnancy. She was age 29 at the time. The procedure was performed by a resident under the supervision of an attending gynecologist. The patient developed abdominal pain after the surgery but she was discharged after 2 days. She returned to the hospital the next day due to severe pain and was readmitted with a presumptive diagnosis of small bowel obstruction. Two days later she was in septic shock and had exploratory surgery, during which a perforation of the sigmoid colon was found. The woman underwent extensive treatment and developed complications and ultimately gangrene in her lower legs, requiring amputation of the lower portion of each leg.

    The patient sued all those involved with her care and claimed the perforation occurred during the salpingectomy and should have been detected at that time. She also contended that the resident was not  properly experienced to perform that procedure. The patient also alleged she was suffering with a distended bowel at the time, which increased the likelihood of a perforation. She further claimed that her postoperative symptoms were not properly recognized and she was prematurely discharged; the exploratory surgery was not performed in a timely manner; and that the amputations could have been avoided with prompt diagnosis and treatment.

    The surgeon and his practice reached a settlement during trial for $2.3 million. The other defendants argued that the colon perforation might not have occurred during the salpingectomy and could have developed after the procedure. They also claimed that sepsis was a known risk of the surgery about which the patient had been informed.

    The verdict

    A jury returned a verdict for the patient and assigned 40% liability to the hospital and the rest of the 60% to five other physicians, including the resident and attending who performed the salpingectomy. The award for damages was $62 million.

    Claim that surgery for rectocele was unnecessary

    Facts

    IN 2006, A NEW JERSEY WOMAN went to a hospital at age 62 for an operation to correct a rectocele. The procedure was performed by a gynecologist, who was precepted by another gynecologist because this was his first surgery using mesh. Two days later, the patient exhibited symptoms of septic shock and was diagnosed with perforation of the rectum.

    A diverting colostomy was performed, but the patient had continuing infections and ultimately required 14 operations with multiple complications, including bowel obstructions, hernias, and abscesses. The woman contended that scarring caused her to be unable to engage in sexual activity, which led to the end of her marriage.

    In the lawsuit that followed, the woman claimed that the rectocele surgery should not have been performed and that she had no symptoms indicating that she even had a rectocele. She alleged lack of informed consent for the procedure.

    The physicians claimed that the surgery was necessary and that the patient did have a rectocele with progressing symptoms. They also contended that the patient had been fully informed regarding the risks and benefits of the procedure and possible complications.

    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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