Patient claims fraud after bladder injury

July 17, 2015

Did the surgeon conceal the extent of a recent injury?

Ms Collins is an attorney specializing in medical malpractice in Long Beach, California. She can be reached at dawncfree@gmail.com.

 

A Louisiana woman underwent a hysterectomy in 2007, performed by her longtime gynecologist. Her bladder was injured during the surgery and a urologist was called to repair the injury.

The patient sued the gynecologist, alleging negligence in injuring the bladder. The patient claimed that the physician had suffered a serious injury in a fall in 2004 that affected his dexterity and that he never informed her of the extent of his injury and risks associated with it.

The physician maintained that the bladder injury was a risk of the surgery about which the patient had been advised and it was recognized and repaired appropriately. A motion for summary judgment was granted for the physician on this claim. He argued that his injury affected only his ability to stand in surgery all day.

The verdict

The hospital settled for $12,000. The jury returned a $30,000 verdict on the fraud count for the patient’s mental anguish.

Analysis

In this case the patient learned that at the time of her operation, the physician had a pending lawsuit against the owner of the premises where he fell in 2004. In his lawsuit the physician claimed that due to this injury, he was unable to continue his surgical practice. An additional claim was filed by the patient for fraudulent concealment of the extent of the physician’s injury and how it may adversely affect her during her operation. The case went to the jury on that charge.

 

 

 

Severe stroke during pregnancy

A 35-year-old Ohio woman was 26 weeks pregnant with her third child in 2012. She contacted her obstetrician’s office complaining of severe headache and abdominal pain. She spoke with a covering obstetrician who allegedly told her there was no need to go to the hospital and that she probably had a gastrointestinal issue.

The next day the patient suffered a massive intracerebral hemorrhage at home. This stroke caused her severe cognitive impairment, loss of memory, partial loss of vision, dysphasia, and partial paralysis of her right side. She requires continuing therapy that may provide her with further use of her right side and recovery of some speech. While she can walk short distances with a cane or walker, she requires the use of a wheelchair for any distance.

The patient sued the obstetrician that took her phone call and claimed negligence in the failure to instruct her to go to the hospital for evaluation of her severe headache.

The obstetrician denied any negligence, contending that the patient’s pregnancy had been normal up to that point and there was no indication that she was at risk for suffering a stroke.

The verdict 

A $10.9 million verdict was returned for the patient, which included $928,188 for the patient’s husband.

 

 

Postpartum death from toxemia

In 2010 a 22-year-old New York woman was receiving prenatal care from her obstetrician. She delivered at term in 2011, and was seen by the doctor 4 days after delivery. The next day she suffered a seizure at home and was transported by ambulance to a hospital, but she could not be resuscitated and died. An autopsy found the cause of death to be toxemia of pregnancy.

A lawsuit was filed on behalf of the patient’s estate, alleging negligence in the failure to properly diagnose and treat her condition after delivery.

The verdict

A settlement was reached in the amount of $775,000.

 

 

Ureteral injury during hysterectomy

A 48-year-old Virginia woman underwent a hysterectomy in 2009. The operation was performed by her gynecologists to treat longstanding complaints of pain and excessive bleeding. The operation was to be laparoscopic but was converted to an open procedure after dense adhesions were encountered. The patient was discharged 3 days later, but returned to the emergency department later that day with complaints of abdominal pain, fever, and nausea. Three days later, an injury to her left ureter that had occurred during surgery was discovered. The woman required 3 reconstructive operations.

She sued the gynecologists and alleged negligence in injuring the ureter and not recognizing it during surgery.

The physicians claimed that the ureteral injury was a known complication of that operation about which the patient had been informed. They also argued that the patient’s anatomy made the injury very difficult to identify intraoperatively.

The verdict

A defense verdict was returned.

 

 

Failure to recommend fetal MRI alleged

A New Jersey woman underwent an ultrasound and amniocentesis at 19 weeks’ gestation in 2011. During the scan it was noted that the fetus’s hands were clenched tightly. The amniocentesis results were reported as normal. The patient delivered at term and the infant was diagnosed with a severe brain malformation. He has difficulty moving, is cognitively impaired, and requires a feeding tube.

A lawsuit was filed, claiming that the physicians should have recommended a fetal MRI, which would have shown a small brain, and claiming that if the parents had been advised of the brain abnormality they would have terminated the pregnancy.

The verdict

A $6 million settlement was reached, with $5 million paid on behalf of the maternal-fetal medicine specialist and $1 million from the obstetrician.

 

 

Small bowel perforation during hysterectomy

A 47-year-old Virginia woman went to her gynecologist in 2010 with a complaint of longstanding pelvic pain caused by uterine fibroids. A laparoscopic hysterectomy was planned and scheduled for 2 months later. The operation was started laparoscopically but converted to a laparotomy when initial visualization revealed dense adhesions.

An on-call trauma surgeon was called to help take down the extensive adhesions that had encased the small bowel and uterus and affixed them to the anterior abdominal wall. He lysed the adhesions bluntly using electrocautery and the gynecologist then removed the uterus, ovaries, and Fallopian tubes and closed the operative site in his usual fashion, including approximating the abdominal muscles with a running suture.

On postoperative day 3, the patient became severely hypotensive and tachycardic and at midnight, she underwent surgery by a second trauma surgeon for suspected bowel perforation and sepsis. A small bowel perforation with diffuse spillage of bowel contents was found and repaired. In the postoperative conversations with the patient’s family and the gynecologist, the surgeon did not mention finding a suture through the small bowel, but 17 days later when he finalized the operative report, he stated that the cause of the perforation was an abdominal wall suture.

The patient was in a medically induced coma for a month and underwent several abdominal washout operations. Several months later she had a complex abdominal wall reconstruction.

The patient sued the gynecologist and alleged negligence in placing a suture through the small bowel.

The physician claimed that he had protected the small bowel with a retractor over the bowel as he sutured the abdominal muscles, and by tenting the abdominal muscle as he loosely sutured the abdominal wall. He also argued that the small bowel was more likely injured during the difficult lysis of adhesions, not from a suture.

The verdict

A defense verdict was returned.

 

 

Family practice physician encounters shoulder dystocia

In 2011 a family practice physician delivered a child at a Minnesota hospital. The infant weighed 10 lb 14 oz. A shoulder dystocia was encountered during the delivery, resulting in a right-side brachial plexus injury to the infant. The patient suffered a 4th-degree extension of an episiotomy. She claimed to suffer fecal and urinary incontinence and pain as a result.

The woman sued the family practitioner (who was an employee of the hospital), claiming he should have recognized from her obstetrical history and her size in this pregnancy that delivery of a large infant was possible. She also claimed that she should have been referred to an obstetrician for a cesarean delivery and failure to do so led to her injuries and her infant’s.

The verdict

A settlement was reached that included $1.2 million for the child’s injury and $300,000 for the patient’s claim.

 

 

Claim that delayed cesarean caused brain damage

In 2003 a District of Columbia woman with a full-term pregnancy noticed that her water broke and there were signs of meconium staining. She called her obstetrician, who was out of town, and spoke to his partner, who advised her to go to the hospital for evaluation. At the hospital fetal heart rate monitoring showed decelerations. The on-call obstetrician saw her and ordered IV fluids and oxygen. The patient’s doctor was called to come to the hospital. He arrived 25 minutes later and a cesarean delivery occurred within the next 16 minutes.

The child suffered from hypoxic-ischemic encephalopathy and was subsequently diagnosed with cerebral palsy. She requires 24-hour care from her parents at the age of 11.

The parents sued all those involved with her care and delivery and claimed that a placental injury of acute villitis had occurred and the child’s brain damage occurred in the last 15 minutes prior to birth. They argued that the on-call doctor should have performed an immediate cesarean and that the attending obstetrician should have told the on-call doctor to do an emergency cesarean at once.

The hospital settled for a confidential amount, and the case proceeded to trial against the physicians, who denied any negligence in the management of the patient and claimed that the injury occurred before the patient’s arrival at the hospital.

The verdict

A defense verdict was returned.  

 

 

Hip infection following cesarean delivery

An obstetrician delivered the child of a 37-year-old Kentucky woman by cesarean in 2011. She was discharged 2 days later. Several days after discharge she developed hip pain. She went to the obstetrician and reported hip pain rated 10 on a scale of 1 to 10. The obstetrician ordered an x-ray, which was reported as normal. The patient continued to have pain and 9 days later was diagnosed with sepsis from a Group B strep infection in her hip. She required a complete hip replacement.

The woman sued the obstetrician, claiming negligence in the failure to diagnose the infection earlier, arguing that a computed tomography scan or magnetic resonance imaging should have been performed.

The physician claimed that ordering the x-ray was proper and the patient’s infection was very rare.

The verdict

A defense verdict was returned.