A 38-year-old Indiana woman underwent surgery in 2006 to remove her ovaries and Fallopian tubes. The gynecologist decided during the surgery that it was unsafe to do the procedure laparoscopically and converted to an open procedure. He was unable to locate or remove the patient’s left ovary and Fallopian tube. The patient’s abdominal pain continued and 3 years later she presented to the gynecologist again with abdominal pain. She was diagnosed with adnexal cysts and admitted to the hospital. She underwent a second operation in 2010 in another effort to locate and removed the left ovary and Fallopian tube. The physician was still unable to locate the structures and finally concluded they were simply not present. Following surgery the patient complained of pervasive pain, which she reported to the gynecologist for several days. On the third day postop she was taken by ambulance to the emergency department, where she underwent emergency surgery. A bowel perforation was discovered and the patient became septic. She had a colostomy, followed by several other operations. Her left ovary and Fallopian tube were eventually located and removed.
The woman sued the gynecologist and alleged he was negligent in his performance of the surgery and that he did not obtain informed consent or warn her of the possibility that bowel perforation could lead to a colostomy.
The physician contended that a bowel perforation is a known complication of the procedure and not indicative of below-standard care. A medical review panel concluded unanimously that the evidence did not support the conclusion that the physician had breached the standard of care.
A defense verdict was returned.
Forceps blamed for brain injury
A Kansas woman presented to the hospital in labor at 36 weeks’ gestation. Her labor was managed by a midwife until it was decided that the fetus was not sufficiently descended into the birth canal, and she was turned over to an obstetrician. She was allowed to push for 1 hour and then the obstetrician applied forceps and exerted traction over 3 contractions, then removed the forceps and delivered the baby 5 minutes later. The infant had a skull fracture, bleeding in the brain, and traumatic epilepsy, and now has cognitive deficits, learning disabilities, and motor problems.
The woman sued her obstetrician and alleged that the fetus had not descended enough to warrant forceps, that she had cephalopelvic disproportion, and that the physician had misapplied the forceps and pulled 6 or 7 times.
The obstetrician contended the fetus was low in the birth canal for outlet forceps, and she properly applied them. She denied all allegations of negligence.
The jury returned a defense verdict.
Bowel perforation during hysterectomy
A 58-year-old Virginia woman underwent a laparoscopic hysterectomy in 2010. She was admitted to the hospital overnight awaiting her ability to have a bowel movement and urinate. She was discharged the next day, even though she still had not done either. She had solid food that evening and experienced immediate nausea, general abdominal pain, and sleeplessness. She presented to her gynecologist in the morning and was promptly admitted to the hospital. She was unable to pass gas for several days, became feverish, and was placed on antibiotics. After 8 days she was transferred to the intensive care unit by a general surgeon due to shortness of breath and tachycardia. She underwent exploratory abdominal surgery on day 11 after her original operation. Several abscesses were found and a 1-cm perforation at the recto-sigmoid colon area was discovered. The surgeon repaired the perforation and created a diverting colostomy. The patient underwent 5 exploratory abdominal washout procedures, and was hospitalized 40 days. She required a colostomy reversal 8 months later and then recovered well.
The woman sued those involved with her original operation and alleged the gynecologist negligently perforated the bowel and failed to recognize it and that he never provided an explanation to her of what went wrong in her surgery.
The gynecologist claimed the hysterectomy was performed without incident, and the perforation was caused by a sudden rupture of a diverticulum 10 days after the hysterectomy. He also admitted that the harmonic scalpel might have caused colon damage during the procedure.
The patient’s colorectal surgery expert opined that the patient did not suffer a ruptured diverticulum and argued that the colon perforation likely occurred within 24 hours of the hysterectomy. Her gynecologist expert witness opined that the patient’s injuries were most likely due to the harmonic scalpel or the power morcellator.
The jury returned a verdict for the patient in the amount of $860,000.