Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.
Overlapping Errors in Inguinal Hernia Repair
At age 59, an Indiana man went to his family doctor complaining of pain in his right groin. He was referred to a surgical group and diagnosed with an inguinal hernia. Surgery was performed in April by Dr. R., a general surgeon.
The day after his discharge, the man began to experience fever and vomiting. He contacted Dr. R.’s office to report these developments, but later claimed that his call was never returned. By the next day, his fever had subsided, but he felt weak and nauseated, and his scrotum had become swollen.
When the patient did speak with Dr. R. later that afternoon, the doctor told him that his symptoms were not unusual. However, the man’s condition continued to worsen; the next day, he had difficulty getting out of bed, and on the fourth day after surgery, he called Dr. R. to report that his scrotum had swollen to the size of a grapefruit. Dr. R. sent him to the emergency department.
At the hospital, Dr. R. performed emergency surgery, during which dead and infected tissue was removed, in addition to a piece of gauze that had apparently been left behind during the initial surgery. It was also discovered that a surgical staple had pierced the patient’s colon, causing a fistula that had become infected.
After the emergency surgery, the patient required ICU care, including ventilation and life support. He also underwent two additional surgeries to remove dead and infected tissue, followed by a third surgery because repair of the colon injury had broken down. After this procedure, the man’s lung collapsed and he experienced cardiac arrest. He spent four weeks on a ventilator.
The patient continued to require rehabilitative care and underwent still one more surgery in August to remove a second piece of gauze from his right groin. He ultimately recovered.
The plaintiff charged the surgeon with negligence for leaving the gauze behind during the initial surgery and for placing a surgical staple in the cecum. The defendant denied any negligence.
According to a published account, a defense verdict was returned.
Risk for Streptococcal Infection Overlooked
In February 2006, a woman who was eight months pregnant experienced abdominal pain and cramping with a mucus-like discharge. Her treating physician ordered a test for group B streptococcal infection.
The next day, the mother presented to a Texas hospital in labor. She gave birth to a girl with the assistance of Dr. O. The infant was cared for by Dr. P. during her three-day hospital stay.
The day after discharge, the infant stopped breathing and was rushed to the hospital, where she was pronounced dead one hour after her arrival. An autopsy determined the cause of death to be streptococcal pneumonia.
The plaintiffs claimed that prophylactic antibiotics should have been administered, and that additional laboratory studies should have been ordered.
The plaintiffs also claimed that within 24 hours of birth, the child lost five ounces and ran a fever for which she was not treated, and that she had an elevated bilirubin level, indicating jaundice. The plaintiffs maintained that the hospital staff should have gone up the chain of command to prevent the infant’s discharge, which had been ordered by Dr. P.
The defendants argued that the mother’s labor proceeded too quickly for antibiotics to be administered, and that a blood culture taken at birth yielded no evidence of infection. The defendants also claimed that the infant’s temperature was normal at the next check and that her bilirubin level was within normal range.
According to a published account, a defense verdict was returned.
Failure to Diagnose Dislocated Knee
A 38-year-old woman sustained a knee injury while staying at a hotel in Arizona. The plaintiff was taken to a regional medical center by ambulance, where an emergency physician diagnosed a tibial plateau fracture but failed to diagnose a dislocated knee and did not perform angiography of the leg.
The patient later required a one-month hospitalization for an occluded popliteal artery, which required a vein graft and fasciotomies of all four compartments.
The plaintiff claimed that if an angiogram had been performed, damage to the popliteal artery and peroneal nerve, which resulted in permanent foot drop, would have been identified and treated.
The plaintiff also claimed that her x-rays were not given to her when she was discharged. If they had been, she argued, her treating physician in California would have diagnosed the dislocation.