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Stomach perforation occurred during removal of polyp – Defense Verdict

On Sept. 15, 2005, an 80-year-old female patient underwent an upper endoscopy to determine the cause of her complaints of difficulty swallowing. Prior to the endoscopy, the patient had reported that food was becoming lodged in her mid-sternal area. She agreed to undergo an esophagogastroduodenoscopy (EGD), and gave her written informed consent for the procedure the day before it was to take place. The patient, who was taking Coumadin for atrial fibrillation, had her Coumadin held for two days before the procedure.

During the EGD, the gastroenterologist located an asymptomatic polyp in the proximal portion of the patient’s stomach that measured approximately 2.9 cm x 1.3 cm. The gastroenterologist determined that, while the polyp was asymptomatic, it presented a danger to the patient due to her risk of bleeding when she would be re-started on Coumadin, and the risk that the polyp would develop into a malignant lesion. The polyp was removed by cautery snare and the upper endoscopy was completed without apparent incident.

Shortly after the EGD, it was recognized that the patient was bleeding from the stomach. A surgical exploration the next day revealed a perforated stomach wall at the site of the excised polyp and repair was attempted. Pathology had revealed the polyp to be a tubulovillous adenoma, a pre-cancerous lesion. The patient’s condition deteriorated and she died on Sept. 24, 2005, of multi-organ and respiratory failure.

At trial, the defense called a gastroenterologist to testify on standard of care and causation, and an oncologist to testify on causation. Plaintiff called a gastroenterologist to testify on standard of care and causation on behalf of the decedent’s estate.

Plaintiff and her expert alleged that the gastroenterologist exceeded the scope of informed consent that was given by the patient.

Plaintiff asserted that the decedent should have been informed of the polyp’s existence and consulted prior to its removal, which should have been undertaken in a subsequent procedure, if at all. Plaintiff also alleged that the gastroenterologist’s technique in removing the gastric polyp was negligent. Specifically, plaintiff alleged that a saline lift technique should have been implemented to protect the stomach wall, and also that excessive cautery was applied during removal of the polyp.

After a three-day trial, the jury deliberated for approximately one hour and 10 minutes before returning a defense verdict.


Type of action: Medical malpractice
Injuries alleged: Alleged wrongful death as a result of a gastric perforation secondary to an upper endoscopy
Court: Danville Circuit Court
Tried before: Jury
Date: April 10, 2013
Demand: First demand – $1,800,000; last demand – $275,000
Offer: None
Verdict or settlement: Defense verdict
Attorneys for defendant: Elizabeth G. Perrow and Daniel T. Sarrell, Roanoke

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