Case #1055: Bowel Perforation
On February 8, the Plaintiff’s Decedent was admitted to the Defendant Hospital with complaints of nausea, vomiting, anorexia, elevated temperature and pain near her colostomy site. On February 9, she had a distended abdomen, no bowel sounds, and had little to no drainage in her colostomy bag. Abdominal x-ray confirmed dilated loops of bowel. During the early morning hours of February 10, the Defendant Surgeon saw the Plaintiff’s Decedent.
When the Defendant Surgeon saw her on February 10, he knew about her previous signs and symptoms and most importantly knew she had an un-reducible hernia at the site of her colostomy . He additionally knew or should have known by the exercise of due care, that her abdominal x-rays revealed dilated loops of bowel, and that the CT scan taken on February 10, was positive for herniation of the large bowel loops through the colostomy with absolute evidence of bowel obstruction. Contrary to the standards of care, the Defendant Surgeon did not take the Plaintiff’s Decedent to surgery until February 11. There, he located the obvious bowel obstruction and reduced it, removing damaged bowel and performing an end-to-end anastomosis.
By February 17, the specialist running the Intensive Care Unit noted that the Plaintiff’s Decedent may have been suffering with an intra-abdominal leak or abscess in her abdomen and that she needed to return to the operating room for surgery to evacuate any infectious material and/or abscess, and make a proper repair. Amazingly, the Defendant Surgeon refused to return her to the operating room.
Daily assessments thereafter charted a downward spiral in the Plaintiff’s Decedent. Her stoma appeared dusky, gray and then necrotic. She developed ascites, bilateral pleural effusion, and left lower lobe atelectasis.
Incredibly, the Defendants negligently waited until February 23, to order another CT scan which, when belatedly completed, was positive for bowel perforation, abscess and fistulous tracts in the left lower quadrant. Additionally, the nurses noted that there was foul smelling liquid draining from the incision. Despite the Intensive Care physicians recommending surgery, the Defendant Surgeon negligently refused. Finally, on February 26, another surgeon operated and found fecal peritonitis, multiple intra-abdominal abscesses, a breakdown of the bowel anastomosis, and an ischemic small bowel. Although the Plaintiff’s Decedent made it through the surgery on February 26, she died shortly thereafter at age 72, leaving behind 2 adult children.