Medical Malpractice News and Views


Welcome to our blog where we discuss current issues in medicine and law. We welcome your comments.

Hospitals Can Be Dangerous To Your Health.

January 14, 2019

The Depression Era bank robber Willie Sutton was quoted as famously saying that he robbed banks because, “That’s where the money is.”  Today, hospitals can be dangerous to your health because, “That’s where the sick people are.”

When you go to today’s hospital, you are entering a large, complex system where there are lots of communicable diseases and lots of opportunities for those diseases to be transmitted to you.  There is even a special name for it:  Hospital Acquired Infection.  If you weren’t that sick when you got there, you just may be after staying a few days.  Here are just some of the risks you face in a modern hospital.

Evolution is alive and well in hospitals.  Bacteria, which could have been knocked out easily with just a shot of penicillin a hundred years ago have evolved to become resistant to even the latest wonder drugs.  Much of the development of antibiotic resistance has been attributed to overprescribing of antibiotics in the past.  According to the Centers for Disease Control, there are at least six superbugs thriving in hospitals today.  They include Carbapenem-resistant Enterobacteriaceae (CRE), Methicillin-resistant Staphylococcus aureus (MRSA), ESBL-producing Enterobacteriaceae (extended-spectrum β-lactamases), Vancomycin-resistant Enterococcus (VRE), Multidrug-resistant Pseudomonas aeruginosa, and Multidrug-resistant Acinetobacter.  Each of these is capable of killing a person.  For some of them we still have one or two drugs that can treat them but, if past history is any guide, the superbugs will soon develop a resistance to them as well.  This is an arms race with bacteria that we are unlikely to win.  There are so many of them and so few of us.  The best solution is to keep patients from getting an infection in the first place.  This is easier said than done.  One thing is recognized as true: Doctors must exercise more discipline in prescribing antibiotics and make sure their patients know how to use them when they are prescribed.

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It is important for hospitals to prevent the spread of infections by isolating patients.  If a patient has a highly infectious disease, that patient should not be in a room with other patients.  Patients who are particularly susceptible to infections, such as older patients or patients who are immunocompromised, should not be exposed to others who have communicable diseases.  Unfortunately, hospitals are run by human beings and are imperfect institutions just as are all other human endeavors.  Mistakes can and will be made.  We just have to hope those mistakes don’t kill people.

It is no secret that doctors, nurses and other health care workers at hospitals spread bacteria from one patient to another on a daily basis.  Doctors’ ties are a well-recognized home for many bad bugs.  The doctor goes from room to room and from patient to patient wearing the same tie and it is rarely, if ever, disinfected.  For that reason, some hospitals have told doctors to get rid of the ties.

Hands that have touched a sick patient should never touch another patient without being thoroughly washed.  This has been recognized since at least the time of Louis Pasteur but is still a problem.  There is not a hospital in the United States that does not require thorough washing after coming into contact with a patient and before coming into contact with the next patient but doctors and nurses continue to skip the hand washing from time to time.  Rules and reminders are apparently no match for human nature and the temptation to skip a step now and then.  Don’t let anyone touch you unless they tell you they have washed their hands.

When you or a loved one are in the hospital, watch for proper hygiene and ask that you not be exposed to other patients who may make you sicker than you already are.  Good luck.

Posted in antibiotic resistant bacteria, blood infections, Doctors, health, healthy living, Hospital Negligence, Hospitals, Infection, medical errors, Medical Malpractice, medical mistakes, Medical Negligence, Nurses, Sepsis |

Malpractice Myths Don’t Match The Facts.

January 07, 2019

Last week I wrote about a study which examined over 20 years of reports to the National Practitioners Data Bank about payments made on behalf of doctors to resolve medical malpractice claims.  I discussed the study findings about the most common forms of malpractice.  This week I want to discuss some of the other findings of the study.

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A common myth perpetuated by the medical industry and the insurance industry is that there is a medical malpractice crisis that requires the government to take away your rights.  As usual, campaigns of this type are based on fear and assume that you won’t take the time to investigate their claims.  They want you to believe that the courts are flooded with frivolous claims and that good doctors are being driven out of practice by frivolous suits.  They want you to believe that, if something isn’t done to fix this, you won’t be able to get medical care, or that what care you do get will cost more than you can afford.  None of this is true.

The data from the National Practitioners Data Bank shows that since 1992, the rate of paid claims against all physicians has declined by over 55%.  During that same time period, the population of the United States has increased by over 62 million people.  That is an increase of almost 25%.  So at the same time that the population has increased by almost 25%, the rate of paid claims has decreased by over 55%.  Claims aren’t going up, they are going down and going down a lot.  Sound like a crisis to you?  Sound like the government should take away some of your rights to solve this crisis?

Many, many studies have found that, while there is a lot of medical malpractice, very few of the victims of malpractice make a claim.  The information at the Data Bank supports this conclusion.  A study by medical researchers at Johns Hopkins Medicine has determined that there are approximately 250,000 deaths each year attributable to medical error.  By contrast, from 1992 to 2014, there were only 35,000 claims paid on the basis of a patient death.  Over the same period of time, according to the Johns Hopkins researchers, there were 5 1/2 million deaths due to medical error.  Why do so few people make a claim?  Much of the disparity is due to the medical profession sweeping malpractice deaths under the rug.  No one goes out of their way to tell families that their loved one died due to medical mistakes.  Secondly, people are not as sue crazy as those who want to take away your rights would have you believe.  Most people just want to put the tragic loss of their loved one behind them.  They are not interested in making a claim, even if they suspect that mistakes were made.

Another important finding to result from the Data Bank information is that there are repeat offender doctors out there who are responsible for a disproportionate number of the paid claims.  The 5% of the doctors with the most claims were responsible for almost 25% of all of the claims paid.  Far from good doctors being driven out of practice by frivolous malpractice claims, bad doctors are allowed to continue to practice and to continue to harm patients.  The bad doctors are ruining things for everyone.  Before you allow the government to take away any of your rights, you should insist that these bad doctors be put out of business.

There is a lot of misinformation out there about medical malpractice.  Take the time to learn the truth.

Posted in disclosure of medical mistakes, Doctors, Health Care Costs, Lawsuits, Malpractice caps, Malpractice costs, Medical Costs, medical errors, medical ethics, Medical Malpractice, medical malpractice cases, medical malpractice damages caps, medical malpractice lawsuits, medical mistakes, Medical Negligence, medical research, plaintiff, Secrecy, tort reform |

Happy New Year – Big Pharma Is Raising Drug Prices Again And People Are Dying As A Result.

January 04, 2019

The price of drugs has been going up and up for the last 20 years as the big drug companies have raised prices over and over again for no reason other than a desire for record profits.  No one in the world pays more for drugs than we do in the United States.  Large campaign donations have made sure that Congress remains docile and does what it is told.  Last year, President Trump announced that he was going to do something about this on behalf of the American people.  Either he is not very good at what he does or he can’t do much as the major drug companies have announced price increases for the new year.  For example, Allergan is raising prices by an average of 10% on a number of drugs.

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Because my 8 year-old- grandson is a Type 1 diabetic, the price of insulin is of major concern to me.  This is a drug that every Type 1 diabetic must have every day or they die.  According to the American Diabetes Association, 7,500,000 Americans rely on insulin.  Its price has tripled over the last 15 years for no apparent reason.  Many who rely on insulin do not have insurance or, if they do, have insurance that does not pay enough for them to be able to afford it.  This has led many to ration their insulin.  According to some sources, as many as 45% of Americans who rely on insulin have rationed it due to cost concerns.  For some, even rationing is not enough and they have died because they could not afford their insulin.  Here and here are stories about young men who died because they could not afford their insulin.

Why does this happen in the richest, best country in the world?  It happens because we let it happen.  We let it happen when we do not demand that our elected representatives make health care affordable.  We let it happen when we do not demand that our elected representatives keep drug companies from ripping us off with price increase after price increase.  It is time to stop letting this happen.  No more Americans should die because they cannot afford their insulin or other life-saving medicine.

Posted in drug companies, General Health, Health Care Costs, Health Insurers, healthy living, Medical Costs, medical ethics, Pharmacies, Rationing |

What Is The Most Common Form of Malpractice?

December 31, 2018

I am often asked what is the most common form of medical malpractice.  Well, now we don’t need to rely on my opinion.  We have an answer based on over 20 years of malpractice suits and payments.

In 1986, Congress established the National Practitioner Data Bank.  It serves as a centralized database for all medical malpractice payments, whether by settlement or verdict, against individual doctors in the United States.  It keeps records of the amount of the payment, the doctor for whom the payment was made, and the nature of the malpractice claimed by the patient.  This information is not available to you or to me but it is available to those who study malpractice issues for research purposes.  A recent article in a prestigious medical journal analyzed over 20 years of payments and discovered some interesting information.  I will address some of the other noteworthy findings in a post next week.

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While this image of a hemostat left inside a patient during surgery is pretty dramatic, surgical errors are not the most common form of medical malpractice, although they are a close second.  The most common form of malpractice is the diagnostic error.  Errors of diagnosis cover a lot of ground but generally mean that a physician reached the wrong conclusion about what is wrong with the patient.

The two medical specialties that had the highest rate of payments for diagnostic errors were pathology and radiology.  I know that I have handled a number of cases in which a pathologist said a tissue sample was benign when it was, in fact, cancerous.  I just finished a case in which the pathologist got it right and identified a cancer but no one bothered to tell the patient, who didn’t learn about the cancer diagnosis for almost two more years.  Radiologists review hundreds of films a week.  From time to time, they miss something.  As with pathologists, the miss usually becomes an issue only when the thing they miss kills a patient or causes a significant injury short of death.

The second most common form of malpractice is the surgical error.  Due to good operating room practices, cases of instruments left in patients have declined greatly.  They still happen on occasion but are rare as the use of checklists has helped make sure that all instruments used in a surgery are accounted for at the end.

One of the most common surgical errors I see is cutting the wrong body part.  A cardinal rule of surgery is that a surgeon must identify the body part before cutting it out.  With the increase in laparoscopic surgery, in which the surgeon is operating while watching a video of the instruments inside the body, the ability to see is not the same as when the patient is “open” and instances of mis-identification are on the rise.  I have had a number of cases in which the surgeon removing the gall bladder and the duct that connects it to the common bile duct coming from the liver cuts and removes the common bile duct by mistake.  Oops!  These cases of mistaken identity are rarely recognized at the time of surgery.  Usually, it takes a few days and some unfortunate complications before the surgeon realizes the mistake.

Third place for most common malpractice goes to medication and treatment errors.  I have written about the fact that medication errors are common in hospitals.  Treatment errors involve everything from failing to be familiar with the patient’s medical records to making a mistake about what is the appropriate treatment for the patient.

There are lots of ways for doctors to make a mistake in your care.  Be as vigilant as you can and you will reduce the chance that you will need to come see me.

Posted in Doctors, Lawsuits, medical errors, Medical Malpractice, medical malpractice cases, medical malpractice claims, medical mistakes, Medical Negligence, Medication Errors, robotic surgery, Surgical Errors |

You Are “Leakage.”

December 27, 2018

Health care costs go up and up.  Hospital chains get larger and larger by purchasing the practices of local doctors.  These two trends are related.

One of the main reasons hospitals purchase the practices of local doctors is to create a health care system which can meet all of the needs of the patient.  This goal is thwarted if the patients are sent out of the system to obtain care which can be provided in the system.  This where the concept of “leakage” comes in.

In the “good old days,” if there were ever such a thing, if you needed care that your primary care physician could not provide, he or she referred you to another doctor who could provide the care or testing you needed.  There was no guarantee, of course, that the doctor to whom you were sent would be top notch and one of the best in town.  You had to trust your primary care physician and hope for the best but at least you knew that the fix was not in.  At least you knew that your doctor was not being forced to send you to a specific person.  He or she could freely choose someone they thought was best for you. It is not that way any longer.

Today, your doctor may work for one of the hospital chains in town.  The hospital chain keeps track of all of your doctor’s referrals.  It knows when she makes a referral and to whom she sends her patients. If she sends a patient to a doctor outside the system, the hospital knows this.  Patients sent outside the system are called “leakage.”  Leakage is a bad thing as far as the hospital is concerned.  Every patient sent outside the system is money lost to the system.  It defeats the whole purpose of buying the doctor’s practice in the first place.

According to a story appearing in the Wall Street Journal, referrals by doctors who work for hospital-owned practices are more likely to be made to another hospital-owned doctor, are more likely to cost more than treatment by a doctor whose practice is not owned by a hospital, and are more likely to be to a higher-quality doctor.

If the doctor working for the hospital doesn’t make enough referrals to doctors in the hospital’s system, the hospital makes sure he or she knows about it.  The hospital “encourages” the doctor to do better.  Of course, the hospital chains deny that they pressure doctors for their own financial benefits.  They claim they are only trying to keep quality up.  It is amazing how trying to keep quality up just happens to put millions of dollars into the pockets of the hospital chains.

We need transparency in hospital charges and hospital business arrangements.  This is our money that is being moved around the health care system and we deserve to get good quality for our money.  Without transparency, this will be hard to do.

Posted in Doctors, Fee for Service, Health Care Costs, Hospitals, Medical Costs, medical ethics, Secrecy |

Fake Jury Verdicts.

December 24, 2018

Perhaps you have received an e-mail from a friend with a list of outrageous jury verdicts.  The lists come in many flavors and with many names.  Some versions are called the “Stella Awards” in “honor” of the lady who was burned by hot coffee at a McDonald’s restaurant and received a substantial jury award.  Each of the verdicts on these lists involves a large jury award against an innocent party and in favor of someone who was responsible for their own injury.  No reasonable person can read one of these lists without asking how can a jury do this?  How can any sane, responsible juror award money for this?  The answer is that they can’t and that the stories are fake.

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If you are not a lawyer, these jury verdict stories may not strike you as made up.  If you are a lawyer at all familiar with trials and jury verdicts, you will immediately smell a rat and for good reason.  Usually the lists give very little information about the parties and where and when the trial took place, so people who are suspicious have very little to work with in trying to see if the stories are true.  And, of course, many people in our society are quick to believe any e-mail they are sent, especially if it confirms opinions they already hold.  Not many people take the time to fact check what they have been sent before forwarding the message to all their friends.

Most of the time these lists don’t say who created them.  A few of them give a fake law firm’s name and ask the recipient to join the firm’s crusade against frivolous lawsuits by forwarding the message to all their friends.  Beware of any message that asks you to forward it to all your friends.  Regardless of the subject, more often than not, these messages are false or misleading.

Even though the lists conceal their creators, the likely culprits are not hard to identify, at least in general.  The obvious purpose of the lists is to poison the jury pool by leading people to believe that the courts are full of frivolous cases and that juries routinely give away too much money for no reason.  Those who benefit from this type of jury attitude are folks like the business community, drug companies, doctors and hospitals, and insurance companies that have to pay judgments when a jury awards money.  Certainly not all of these folks have a hand in creating these lists but someone on their side does and the jury attitudes these lists create or reinforce benefit them.

I suppose that in times like this it should not be surprising that someone will use the power of the internet to spread lies with the goal of subverting our jury system.  It is still disappointing, however.  If you get one of these lists, be skeptical.  Don’t believe it or forward it without fact checking it first.

 

Posted in Doctors, drug companies, Fraud, Hospitals, Lawsuits, Malpractice caps, Medical Malpractice, plaintiff, tort reform, trial, Verdicts |

What To Do If You Think You May Have Been The Victim of Malpractice.

December 17, 2018

While sometimes it may be obvious that you have been the victim of medical malpractice, most times it will not be clear at all.  The obvious times involve the kinds of mistakes that can’t be swept under the rug.  They involve mistakes such as operating on the wrong side, operating at the wrong level, operating on the wrong patient, wrong medications, etc.  You get the idea.  Everything else will usually be explained as just a bad result that occurred in spite of the excellent care you received.

So how do you know if you were the victim of malpractice?  Here are some suggestions.

Did something unexpected happen or was your injury something they told you was one of the risks?  If what happened to you was unexpected, that is a strong reason to consider that you may have been the victim of malpractice.  Even if what happened to you was one of the possible outcomes you had been warned about does not mean that your injury was not the result of malpractice.  When they tell you that your injury was just one of those things, don’t just accept what you are told as being the truth without giving it some thought.

Did you notice a change in the way you were treated by your health care providers after your injury?  Were there long periods when you found it hard to get information or answers about what happened to you?  Were the answers you got consistent or did they contradict each other?  Did the story keep changing?  Did it appear that some providers were blaming others for what happened?  Did it appear that any of the doctors or nurses were mad about what happened to you?  Did they stop talking to you in the way they did before?  Sometimes, when the providers know that there has been malpractice, they will try to avoid discussing the issue with the patient.  They may even begin avoiding the patient to the extent possible.

Is there a nurse or health care worker who seems particularly empathetic?  Sometimes you can ask a caring person like this what happened and they will tell you or suggest you contact a lawyer.

Use the internet.  There is likely a lot of information out there about the injury you suffered.  You can read about it and it may help you figure out what happened or at least suggest questions you should be asking.

Get your medical records and review them to the extent you are able.  You may find clues in the medical records to explain what happened.  Watch for the times of events.  Was there a long delay anywhere?  Were there times when the nurses could not reach the doctors?  Were critical test results promptly reported to the doctors?  Did the doctors promptly respond to critical information?

Ask your neighbors.  Most of us have a neighbor or friend who works in health care.  That person may be a good resource.  They can often tell you whether what happened to you sounds like a problem or not.

Finally, if after all that you still have questions, call an experienced malpractice lawyer.  Every experienced malpractice lawyer will have professional staff who know what to look for and can ask the questions that may indicate the presence of malpractice.

I hope you are never the victim of medical malpractice, but, if you are, we are here to answer your questions.

Posted in arizona certified medical malpractice lawyers, disclosure of medical mistakes, Doctors, Hospital Negligence, Hospitals, medical errors, Medical Malpractice, medical malpractice lawyers, medical mistakes, Medical Negligence, medical negligence lawyers, Nurses, Secrecy, Surgical Errors |

Prostate Cancer News.

December 13, 2018

The New England Journal of Medicine just published the results of a 30 year study from Scandinavia of the effect of radical prostate surgery on the risk of death from prostate cancer.  The study sample was 695 men, all of whom had their cancers detected clinically.  This means that the cancer was large enough to be discovered either by the patient or by the physician during examination.  The study participants were enrolled before the advent of widespread PSA testing.

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The study participants were divided into two groups.  Members of the first group underwent a radical prostatectomy, a surgery in which the prostate gland is completely removed.  This surgery has a number of unfortunate side effects, including a high risk of incontinence and impotence.  Members of the second group were monitored carefully for changes in their tumors.  This is called “watchful waiting.”  In the event there is a significant change in the tumor, the doctors will begin treatment.

The study concluded that for men with a clinically detected, localized prostate cancer, radical prostatectomy increased the length of life by almost three years.  The results need to be considered carefully, however, as they may not apply to most patients whose prostate cancer is detected today.  In the first place, in order for a prostate cancer to be detected clinically, the tumor must be a large one.  Since most prostate cancers are slow growing, a large tumor is usually one that has been in the body for some time.  With the advent of widespread PSA testing, most men who are discovered to have prostate cancer will have their tumors detected much earlier than the men in the study.  In other words, the men in the study had what we would consider today to be advanced prostate cancer.  Had they been discovered earlier and enrolled in watchful waiting, they may have received treatment earlier than they did in this study.

Secondly, the longer length of life was only enjoyed by those whose tumors had not escaped the local area and whose Gleason scores were low.  The Gleason score is a measure of determining the aggressiveness of prostate cancer.  A high Gleason score indicates an aggressive tumor, which is more likely to be fatal.  The same is true of cancers which had spread outside the local area by the time they were discovered.  Those patients also had a higher risk of death due to the prostate cancer, but not as high as those with elevated Gleason scores.

Because of these limitations inherent in the study, one of the lead authors, Dr. Anna Bill-Axelson, says surgery may be beneficial for those with high grade, aggressive tumors but active surveillance is a good alternative for those who are otherwise healthy and who have small, slow growing tumors.  The older you are when your prostate cancer is discovered, the more likely you are to die with it than from it.

Each of the big three prostate cancer treatments, radical prostatectomy, radiation and brachytherapy have a high risk of leaving the patient incontinent and incapable of having a functional erection.  For this reason, these treatments should not be undertaken lightly.  Many treaters suggest they be used only in younger men and then only if the tumor is aggressive and watchful waiting has failed.  As many articles have suggested, however, it is often difficult to explain to friends and family that you have prostate cancer and are only going to watch it for the time being.  Many men end up getting pushed by family and friends into aggressive treatment, which they later regret.

The general consensus among doctors who treat prostate cancer is that we treat too many men who don’t really need it.  If you are diagnosed with prostate cancer, take the time to consider your options.  Don’t rush into treatment.

 

 

Posted in Cancer, Doctors, healthy living, Prostate Cancer, prostate cancer testing |

Generic Drug Price Fixing.

December 12, 2018

“Generic” is the name given to drugs that are not protected by patents.  Anyone can make a generic drug.  Because they are not protected by patents, it is anticipated that competition will drive down the prices of generic drugs to the benefit of all consumers.  Anyone who has been paying attention to drug prices in this country knows that the opposite has been happening; prices of generic drugs have been skyrocketing.  Turns out the big generic drug manufacturers have been fixing prices.  Take a look at this story from the Washington Post.

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It is against the law in the United States for companies to get together and fix prices or divide markets or engage in any other type of anti-competitive behavior.  Of course, a lot of things are against the law but people do them anyway because it is a way to make money.  That seems to be what is happening here.  According to the prosecutors, there has been corruption on a massive scale among the manufacturers of generic drugs.  Since generic drug sales in 2017 were $104 billion, there is a lot of money to be made in keeping prices up.

There was a time when the generic drug market operated as intended due to principles of supply and demand.  Competition was described as cutthroat and it kept prices low.  But then a change took place.  Prices for generic drugs began to climb and climb quickly for no apparent reason.  Furthermore, it was not just the generic drugs of one manufacturer that were increasing in price, the competing drugs of other manufacturers were going up as well, seemingly in lock step.  Clearly, something was happening.

In the absence of collusion, when one manufacturer raised its prices, the other manufacturers should have seen an increase in demand for their competing drugs.  This would have forced the manufacturer who raised prices to either back down or be driven out of the market.  Law enforcement, consumer advocates and health insurers noticed and began to investigate.

In late 2016, the attorneys general of a number of states got together and filed an anti-trust suit alleging price fixing for two generic drugs.  As the result of information learned during the discovery process, that suit has gained the participation of more states and has grown to include over 300 generic drugs and 16 manufacturers.  Based on comments from those in a position to know, it would appear that the evidence against the manufacturers is strong.  In a parallel federal criminal case, two former executives of Heritage Pharmaceuticals have pleaded guilty and are cooperating the Justice Department prosecutors.

While the manufacturers deny any collusion, they offer no explanation for the sudden and dramatic increases in generic drug prices among companies that should be strong competitors of each other.

The whole thing stinks.  I have written about the lobbying power of the drug companies and the influence it has bought in Washington, D.C.  Your representatives in Washington don’t want to offend their campaign contributors by reining in prices.  It is instructive that the efforts to hold the drug companies accountable are being led by the states, despite this being a national problem that calls out for a national solution.  The states are stepping in because Congress won’t act.

There is so much money changing hands in health care that it is inevitable greedy people will look for ways to game the system and take money out of our pockets.  We have to be constantly vigilant to uncover their schemes.  Looks like these legal actions are a good start.  Watch this space.  I predict the generic drug manufacturers are going to have to settle.

 

Posted in drug companies, Fraud, Health Care Costs, Health Insurers, Lawsuits, Medical Costs, Medicare, Secrecy |

$13M Medical Malpractice Verdict in New York.

December 12, 2018

There is a lesson to be learned from every medical malpractice verdict.  A recent verdict in New York City is no exception.

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A 43 year old wife and mother of three underwent what should have been a minor procedure to remove a polyp from her colon.  The polyp was burned off using an electric cautery device.  Although he did not know it at the time, the surgeon burned a hole in the patient’s small bowel.  The hole allowed bowel contents to escape into the body.  Infection is almost always the result and that is just what happened here.

I frequently see cases in which there is an accidental injury to the bowel.  It occurs most often in laparoscopic surgery where the surgeon does not have the same ability to see the operative field as he or she does in an open surgical procedure.  Usually it is not medical malpractice to cause an accidental injury during one of these procedures.  An accidental bowel injury is a risk of the procedure.  However, because it is a known risk of the procedure, the surgeon must be careful at the end of the procedure to inspect the area and look for evidence of a bowel injury.  Even then the surgeon may not find the bowel injury and may send the patient home with bowel contents leaking into the abdominal cavity.

Because patients can be sent home with bowel injuries even when the surgeon has been careful during the procedure and even when there was no evidence of an injury during the end-of-surgery inspection, the surgeon must be alert for post-operative complications that could be the result of a bowel injury.

The patient here was in excruciating pain for days after the surgery and had to take lots of pain medication.  Although the newspaper story does not mention it, it is almost certain that her vital signs and lab values were abnormal.  These are red flags that should have caused the surgeon to order tests for possible bowel injury.  However, it was not until four days later that the surgeon ordered a CT scan of the abdomen which revealed the likely bowel injury.  Although the surgeon took the patient back for immediate, emergency surgery, the infection had progressed so far that she could not be saved.

The jury deliberated for less than a day before awarding $3M to each of the three children, whose ages were from 17 to 13, and $7M to the husband.

So what are the lessons to be learned here?  The first and most important is that the patient and the patient’s family must also be alert for the possibility of an unrecognized bowel injury following laparoscopic surgery in the abdominal area.  They should be alert for unexpectedly severe pain that does not go away.  If severe, unrelenting pain is present or there are any other signs of infection, they need to be proactive in insisting that something is wrong.  Don’t let yourself be put off with the reassurance that severe pain following these procedures is normal.  It is not.  Keep after the doctor and the doctor’s staff until something is done to rule in or rule out the presence of a bowel injury.

Bowel injuries produce infections.  If the infection is caught in time, all will be well.  On the other hand, if the infection is allowed to persist, it will enter the bloodstream and overwhelm the body’s ability to fight it.  When that happens, blood pressures crash and organs fail.  This is called septic shock.  Many patients, like the poor lady here, cannot recover from it.

Be alert.  Be proactive.  Don’t accept every reassurance, especially if you think something is wrong.

Posted in blood infections, Doctors, Infection, Lawsuits, medical errors, Medical Malpractice, medical malpractice cases, medical malpractice lawsuits, medical mistakes, Medical Negligence, Misdiagnosis, plaintiff, Sepsis, Surgical Errors, Verdicts |