A 32-year-old patient who was 24 weeks pregnant presented to the emergency department with reports of severe abdominal pain, cramping and nausea. She also reported to hospital staff that she had been born with a condition called gastroschisis—a birth defect where a baby is born with her intestines on the outside of the abdominal wall.
Ultrasound, MRI and other testing could not conclusively identify the source of plaintiff’s intense abdominal pain. The admitting physician sought multiple consultations from specialists, including an obstetrician, gastroenterologist and surgeon. In the late afternoon, before the plaintiff was admitted to the hospital’s surgical intensive care unit, the consultant surgeon came to bedside, examined plaintiff, and determined that her clinical picture was not consistent with an acute surgical abdomen. The surgeon concluded plaintiff did not require an operation at that time. Approximately three hours later, after being informed by the nursing staff that plaintiff’s condition had deteriorated, the surgeon returned to her bedside and elected to perform emergent surgery in light of her changed clinical picture.
During the operation, the surgeon discovered a rare colonic volvulus. A partially gangrenous bowel had resulted from compromised blood flow. The surgeon resected and removed the gangrenous portion of plaintiff’s bowel and re-attached the remaining healthy portions. Approximately two-thirds of plaintiff’s bowel was removed.
One week later, while recovering in the hospital, plaintiff’s condition worsened. MRI and CT studies showed free air in her abdomen. The surgeon elected to perform a follow-up operation, during which a gastric perforation was discovered as the source of the free abdominal air. This was repaired with a gastrostomy tube. The defense asserted this gastric perforation was caused by a perforated stress ulcer. Plaintiff claimed this perforation was actually a puncture caused by negligent surgical technique during her first surgery one week earlier. The perforation was repaired and plaintiff was discharged about three weeks later.
At trial, plaintiff alleged that had her first surgery been performed three to five hours earlier, her colonic volvulus would have been discovered sooner and the portion of her bowel that was removed could have been saved, thus improving her quality of life currently. The defense contended that plaintiff’s outcome would have been unchanged, irrespective of the timing of her initial surgery, and that she suffered no ill effects due to the removal of most of her colon.
The defense called a general surgeon and a colorectal surgeon to testify on behalf of the defendant surgical practice.
Plaintiff called a general surgeon as an expert witness. The jury returned a defense verdict after less than two hours of deliberation.[12-T-104]
Type of action: Medical malpractice
Injuries alleged: Delay in surgery resulting in a delayed diagnosis of a colonic volvulus
Court: Roanoke Circuit Court
Tried before: Jury
Date: April 19, 2012
Demand: $3,000,000 ad damnum
Verdict or settlement: Defense verdict
Attorneys for defendant: Elizabeth G. Perrow and Daniel T. Sarrell, Roanoke