Legally Speaking

October 1, 2005

Bowel perforations found after hysterectomy

Bowel perforations found after hysterectomy

A 53-year-old Illinois woman underwent a total abdominal hysterectomy performed by her gynecologist in 2001. Bowel perforations were subsequently found and she developed peritonitis, which required removal of a portion of the bowel and creation of a temporary ileostomy. Later, surgery also was required for repair of a ventral hernia.

The woman sued, claiming that the physician negligently performed the operation.

Death after bowel perforation from uterine fibroid surgery

A 60-year-old woman underwent a laparotomy for removal of a uterine fibroid after an unsuccessful laparoscopic procedure. She developed postoperative infection, acute respiratory distress syndrome (ARDS), and bowel perforation with abscess. Surgical exploration and repair was performed 2 weeks after the initial surgery, but the patient died of complications about a month later.

The lawsuit filed in Illinois on the woman's behalf alleged that the physicians and hospital failed to timely diagnose and treat the perforated bowel and to order stat CT scans and a surgical consult.

The defense argued that a stat CT scan and surgical consult were not indicated on admission to ICU 3 days after the original surgery. Instead, they claimed, the CT done 3 days later with aspiration and drainage was appropriate in light of the ARDS diagnosis, and these complications were treated appropriately.

The jury returned a defense verdict.

Complications from D&C necessitated C/S

A New York woman in her late 30s underwent a D&C in 1993 after a miscarriage at 13 weeks' gestation. The in-office procedure was performed by her obstetrician. The patient had complications, and during exploratory surgery months later, a uterine perforation was found and the bowel was resected. A colostomy performed during the procedure was closed 4 months later. The woman subsequently had a myomectomy. Thereafter, she delivered three healthy male infants, all by C/S.

The woman sued the obstetrician, claiming negligence in perforating the uterus and bowel during the D&C, which necessitated the colostomy and required that her deliveries be by C/S.

The physician argued that the injuries were a known risk of the procedure and that the C/S were necessitated by the fibroid removal surgery, not the uterine injury during D&C. Summary judgment was granted to the defense, with the judge finding no question of fact to present to the jury.

Obstructed ureter after hysterectomy

A Virginia woman in her 40s was treated by her gynecologist for some time before an undisclosed disorder necessitated a hysterectomy. After the operation, the patient was discharged in good condition. Twelve days later, she began to have urinary tract pain and discomfort. She was examined by her physician, who monitored her for a period of time before suspecting an obstructed ureter and possible fistula. He referred the woman to a urologist, who surgically corrected the fistula and obstruction. The patient made a full recovery.

In her lawsuit against the gynecologist, the woman claimed that he used substandard surgical techniques in performing the hysterectomy.

The physician claimed that the obstruction and fistula were known complications of a hysterectomy and the jury returned a defense verdict.

Kidney removal after hysterectomy

A 74-year-old Illinois woman underwent a total abdominal hysterectomy in 2000. During the operation, her ureter was inadvertently tied off and it was not adequately checked for injury. Four days later, the patient was discharged from the hospital. Over the next 13 months, she complained to her primary care physician of feeling bloated, and a CT scan showed blockage of the right ureter and hydronephrosis of the right kidney. The kidney was removed and the woman died from an unrelated heart attack a little over a year later.

A lawsuit filed on behalf of her estate alleged negligence for failure to verify the integrity of the ureter before discharge.

The physician argued that an interrupted blood supply to the ureter caused it to scar down over the next year, which was not detectable on discharge. A $75,000 settlement was reached with the hospital before trial. The jury deadlocked at 11-1 and the parties then agreed to accept a verdict, which was for $108,765 against the physicians.