On September 5, 2014, the plaintiff complained of mild soreness at the incision site. However, she was afebrile, voided, and tolerated liquids. She was then discharged home on Oxycodone, Motrin and Senna. She was instructed to continue all prior medications. No antibiotics were prescribed.
The plaintiff followed up with Dr. A’s office on September 9, 2014. She reported that she was voiding, had a bowel movement, and was ambulating. On September 13, 2014, the plaintiff was admitted to the Defendant Hospital with complaints of oozing from the vaginal incision site. Her vital signs were stable and she was afebrile with a pain score of 5/10. She reported 2 days of peri-incisional erythema and separation of the incision on the day of admission. She had called Dr. A’s office and Keflex was prescribed for presumed cellulitis.
The plaintiff had a visible 2-cm abdominal wall incision with 10-cm tunneling above the fascia. Purulent drainage was expelled, drained, and debrided and the wound was packed while in the emergency room. The plaintiff was admitted for wound infection and was started on wet-to-dry dressing changes, Ancef, and Bactrim. Over the next 2 days, her erythema decreased with dressing changes and Gram stain of the drainage showed neither white blood cells nor bacteria. Cultures showed moderate Staph Aureus. The dehiscence was noted to be 2.5 cm deep to fascia and 1.5 cm wide. However, the plaintiff remained afebrile without evidence of sepsis. She was discharged home on September 16, 2014 on oral clindamycin.
On September 22, 2014, the plaintiff was seen by Dr. A after being hospitalized for a wound infection. However, the wound was slowly healing and measured 3 cm deep with some tracking superiorly. Dr. A noted that the plaintiff had no complaints of fever, chills, bulge or incontinence. She was to follow-up in 2 weeks, at which time a pelvic exam would be done.
On September 26, 2014, VNS called Dr. A’s office and reported that there was yellow-green discharge from the wound. However, there was no odor, increased drainage or fever. An office appointment was arranged for the next Monday. The plaintiff returned to Dr. A on September 29, 2014 for a follow-up visit. At that time, her wound was examined and repacked. On October 6, 2014, the plaintiff was seen for a follow-up visit for her wound and for complaints of urinary frequency. At that time, it was noted that her wound was healing and was 2 cm deep and 3 cm long. At the next visit on October 20, 2014, Dr. A noted that the plaintiff’s wound was almost closed. No prolapse was appreciated on exam and estrogen cream was prescribed for atrophic vaginitis.
On October 27, 2014, the wound was noted to be closed and the plaintiff reported no pain or incontinence. At a follow-up visit on February 1, 2015, the plaintiff complained of double voiding and incomplete emptying; she was treated with Macrodantin. At her last reported visit with Dr. A, on March 16, 2015, she complained of rectal bulge (small hemorrhoid noted on rectovaginal exam), “occasional” fecal urgency and “some” incomplete bladder emptying. A bowel regimen was started and she was referred for pelvic floor exercises. On a form entitled “Patient Global Impression of Improvement,” the plaintiff indicated that her postoperative condition was “normal” and that when compared to her preoperative condition she was “much better.”
On July 28, 2015, the plaintiff presented to her private ob/gyn, Dr. E, with complaints of a recurrent prolapse. However, Dr. E’s note includes no exam findings consistent with recurrent prolapse. On November 16, 2015, the plaintiff underwent right carotid endarterectomy at Codefendant University Hospital, which was complicated by transection of the carotid artery. Postoperatively she had a right middle cerebral artery infarction with left hemiparesis. There was no reference to any urologic complaints.
The plaintiff alleged that the defendants were negligent in performing a laparoscopy; in causing an enterotomy; in causing the need to perform an exploratory laparotomy and repair; in failing to properly and sufficiently plan the laparoscopy; in failing to perform appropriate preoperative testing to assess adhesions; and in failing to take all measures necessary to prevent any complications from the laparoscopy. Plaintiff argued the procedure should have been commenced open and opposed to laparoscopically. In addition, plaintiff contended Dr. B “botched” the first prolapse repair, leading to the cascade of events that necessitated future surgeries and complications.
As a result of the alleged negligence, the plaintiff asserted injuries including large recurrent prolapse, urgent urinary frequency, nocturia, and loss of services to her husband.