Surgical Negligence - Medical Malpractice

Prior to trial, WRSMH attorney Jason Rubin obtained a $1 million settlement in a case involving a 28-year-old married mother of two. She sustained a bowel perforation, sepsis, and the need for an ileostomy for five years as a result of the alleged negligence of two surgeons who failed to perform a temporary bowel diversion during earlier exploratory laparotomy surgery to treat a small bowel obstruction.

In 2010, plaintiff was diagnosed with cervical cancer and treated with surgery and radiation therapy. Approximately one year later, she developed abdominal pain and went to defendant’s hospital. She was then diagnosed with radiation colitis due to the radiation therapy. This was treated conservatively with antibiotics and she was sent home.

Approximately one month later, she returned to the defendant’s hospital with recurrent abdominal pain, vomiting, and no bowel movements for three days. She was admitted and, after a workup with an abdominal CT scan, diagnosed with a small bowel obstruction. She was treated with a nasogastric tube to decompress the bowel.

Unfortunately, she did not improve with this treatment and went into surgery for an exploratory laparotomy with lysis of adhesions. During the surgery, the surgeons noted that the rectosigmoid colon was very hard and inflamed; that it was attached to the uterus and pelvic sidewall and that the serosa (outmost layer) was abraded and denuded. The surgeons sutured the sigmoid colon but did not perform a bowel diversion (i.e., colostomy or ileostomy).

Within a week of this surgery, plaintiff felt a "pop" in her abdomen with experienced severe pain. She was taken immediately to the OR for exploratory surgery where it was noted that there was a perforation of the sigmoid colon in the area where the suture had been placed. There was significant leakage of stool into the peritoneal cavity. An ileostomy - a procedure where the small intestine is diverted through an artificial opening in the abdominal wall - was performed. Our plaintiff remained hospitalized in the ICU for approximately one month and was then transferred for rehabilitation. During the ICU stay, she was in septic shock and required intubation for several days. She required a PICC line, which caused her to develop a deep vein thrombosis in her arm.

Our client was required to have the ileostomy in place for five years before she underwent a reversal.

We claimed that the surgeons were negligent for failing to perform a bowel diversion during the exploratory laparotomy in light of the fact that the sigmoid colon was hard, inflamed, and denuded. We also claimed that, due to the extensive inflammation, it was negligent to place a suture in the sigmoid colon. A bowel diversion would have allowed the sigmoid colon to heal and a reversal could have then been performed months later. However, because a diversion wasn’t done, this allowed the sigmoid to later perforate, which made doing a subsequent reversal much more complicated, requiring our client to live with the ileostomy for five years.

If the case had gone to trial, the defense would have argued that if a bowel diversion had been performed during the exploratory laparotomy, plaintiff still would have required an ileostomy for years because radiation colitis takes years to heal. Further, they would have argued that plaintiff’s obesity was the reason that a reversal wasn’t performed earlier.

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