Are injuries during abdominal surgery to be expected, or are they because of negligence?

A Virginia woman was treated by her gynecologist for abdominal pain and other symptoms related to endometriosis and underwent abdominal laparoscopy.

The physician claimed that gastric perforation is a rare but recognized complication of abdominal laparoscopy that can occur without negligence. He also claimed that the patient's gastric problem was because of a psychosomatic disorder and was not reflux disease. He suggested that if she really did have gastroesophageal reflux, it was related to a hiatal hernia.

A NORTH CAROLINA WOMAN in her mid-40s underwent an elective vaginal hysterectomy and bilateral salpingo-oophorectomy, which was performed by her gynecologist. Although both ureters were accidentally severed during the procedure, this complication was recognized, and both ureters were repaired. In her lawsuit, the woman claimed that the ureters should have been isolated and protected before the uterus and Fallopian tubes were removed. The physician claimed that the patient had abnormal anatomy that made isolating her ureters extremely difficult and that both ureters were repaired without subsequent long-term injury anticipated.

When consenting to laparoscopy or vaginal hysterectomy, most patients understand that laparotomy or another open procedure may result if a complication occurs or if difficulty with the minimally invasive procedure arises. Although neither of these cases claimed a lack of informed consent, the plaintiffs still alleged negligence in the occurrence of a known complication with little or no long-term injury resulting from its resolution. Fortunately, both of these cases were successfully defended but did involve lengthy discovery processes and jury trials, which were both costly and stressful for those being sued.

MS COLLINS is an attorney specializing in medical malpractice in Long Beach, California. She welcomes feedback on this column via e-mail to

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