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Woman Sues After Surgeon Fails To Recognize He Cut Hole in Bowel During Surgery

This 73-year-old woman was fearful of surgery.

Despite the pre-cancerous lesion discovered from Pap smear results, she did not initially agree to the gynecological surgeon’s recommendation for a hysterectomy and removal of her ovaries and fallopian tubes.

A month later this non-English speaking woman returned, and the surgeon discussed and reviewed the risks of the procedure with the assistance of an interpreter. She signed the consent form but said she wanted to first discuss the surgery with her daughter.

Seven months went by before she returned. Once again they discussed the risks of the surgery, with an interpreter present and both the surgeon and patient signed and dated the consent form.

During the procedure, the surgeon discovered dense adhesions between her bladder and uterus, and between the uterus and colon. The woman lost 600cc of blood and one unit of blood was given.

The woman had a postoperative intestinal obstruction lasting several days and she also was given antibiotics for a low-grade fever and pneumonia that followed the surgery.

Five days after the surgery, the patient complained of severe abdominal pain and nausea. Her heart rate was 102, her temperature was 101.5 and her abdomen was distended.

Later that night, the surgical resident on rotation ordered an abdominal X-ray (KUB), unaware the hospital did not have 24-hour radiology consults. When Radiology reviewed the image the next morning, the X-ray showed a significant amount of free air, and the radiologist contacted the surgeon at 10:20 a.m. Six hours later, a CT scan confirmed a large perforation or hole in the sigmoid colon.

Emergency surgery was performed, revealing a 1.5 cm perforation in the colon. A diverting colostomy and Hartmann’s pouch were created for the patient. She required an extended course of IV antibiotics and admission to a rehabilitation facility for three weeks. She had planned to have the colostomy reversed, but canceled due to fear of undergoing another surgery.

This woman’s attending surgeon, the hospital and two surgical residents failed to recognize they perforated her bowel during surgery, which resulted in infection and the need for repair with a colostomy. This case was resolved through binding arbitration in favor of the patient for $450,000.

Deciding in favor of the patient, the arbitrator determined two facts:
1) The perforation was a result of the procedure, and
2) The delay in response to symptoms and test results showing an infection was negligent.

Other findings from this case that lead to a successful settlement for this woman include:

Although the surgeon maintained phone contact with the resident, he did not see the patient for five days after the surgery. Familiarity with a patient, especially with a language barrier, may help with communication issues, such as describing pain or with the fact that an X-ray needs to be checked as soon as it is taken.

Language barriers and cultural issues suggest the woman’s postoperative pain may not have been fully recognized. If a patient has challenges speaking with primary caregivers, it is possible that subsequent providers will also have communication issues. Physicians need to be make sure their verbal communications are understood. The use of translators and documentation are very important here.

The resident was unaware that the Radiology department would not read the X-ray until the next morning. Failing to be certain that all residents are familiar with what kind of support is available, and when, is putting patient care at risk.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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