About two hours after the patient’s arrival, the emergency physician called the defendant on-call surgeon to apprise him of the patient’s condition and to ask him to admit the patient to the ICU, which the defendant agreed to do. The defendant did not see the patient for three hours, by which time he was coding.
The patient was immediately taken to the operating room, where the defendant found and repaired a severed left internal iliac artery. The surgery took four hours, after which the patient developed disseminated intravascular coagulation and multiorgan failure. He died the next day.
The plaintiff alleged negligence in the defendant’s failure to respond immediately to the emergency physician’s call.
The defendant claimed he had not been told that the decedent was in extremis and hemorrhagic shock, or that the emergency department staff needed his help. The defendant also maintained that the emergency physician did not call him a second time. According to the defendant, he had been at the hospital for about 90 minutes after the call from the emergency physician but was not paged by the ICU staff about the decedent’s deterioriating condition for another 90 minutes.
According to a published account, a defense verdict was returned. A defense verdict had been returned earlier on claims against the emergency physician.
Unusually Severe Pain After Colonoscopy
A 49-year-old Michigan woman with persistent complaints of abdominal pain and diarrhea underwent a colonoscopy at a hospital outpatient surgery department in November 2003 to rule out colitis. After the procedure, which was performed by a gastroenterologist, Dr. T., the patient was given standard instructions for follow-up care, including contacting Dr. T. in the event of any unusual developments. She was also advised to follow up with Dr. T. in three to four weeks.
Later that afternoon, a call was made to Dr. T.’s receptionist to report that the patient was experiencing severe pain. On being informed of this, Dr. T. prescribed a 24-hour supply (five tablets) of hydrocodone/acetaminophen. The woman, who had a history of frequent pain medication use, was instructed to go to the hospital ED if the pain persisted.
The next day, the hospital’s anesthesia service made a routine postoperative phone call to the patient, whose husband reported that she had been experiencing severe left lower quadrant pain since the previous evening. He was told to contact the doctor the next day if her condition did not improve. No call was made.
Six days later, when the woman’s husband was helping her dress, he noticed a bruise on her stomach. She was taken to the hospital, where CT revealed a splenic hematoma. An exploratory laparotomy performed the next day revealed adhesions between the colon splenic flexure and the spleen. A splenectomy was performed. During a second exploratory laparotomy about two weeks later, a left subphrenic hematoma was found and drained. The patient was discharged in February 2004.
In addition to the splenic problem, the woman had an esophageal stricture, which left her unable to eat. She was given J-tube nutrition, which was not sufficient. She experienced several episodes of dehydration and was losing weight as a result of malnutrition.
Her case was transferred to another physician group. An operative surgical repair was considered but could not be performed unless the patient weighed at least 115 lb. She died in December 2004 weighing 70 lb.
The plaintiff claimed that the decedent suffered a large subcapsular splenic hematoma after the colonoscopy, necessitating the splenectomy. The plaintiff contended that the multiple surgeries and esophageal stenosis led to dehydration and malnutrition, preventing the possibility of treatment and resulting in the woman’s death.
Dr. T. claimed there was no negligence and that neither the decedent nor her husband followed up with him regarding her pain. Dr. T. argued that the decedent had reported what are known complications of a colonoscopy.
According to a published account, a defense verdict was returned.