Case# 4006 Bowel Perforations Caused By Surgical Error
On August 11, the Plaintiff, a 30 year-old gentleman, was seen by the Defendant because of unwanted abdominal fat. He was noted to be 5’9” tall and weighed 267 pounds. After a history and physical examination, liposuction was recommended. On September 28, 2007, Defendant GYN surgeon performed liposuction on the Plaintiff at her outpatient surgical center.
On September 29, the Plaintiff followed-up with the Defendant at her office. There, the Plaintiff was clammy, dizzy and not feeling well. The Defendant was unable to get an audible blood pressure, noted his pulse to be 120 and a heart rate of 30. She infused 1300 cc of saline over 50 minutes. The Plaintiff was then taken to the home of the Defendant’s office manager for observation. The office manager had no medical background or training. The Plaintiff spent the night at the office manager’s house, was seen there by the Defendant the next day and sent home.
On October 2, the Plaintiff returned to the Defendant’s office for follow-up. He reported feeling clammy and was tachycardic and feverish. During the examination, the Plaintiff vomited and complained of abdominal pain. The Plaintiff also had 30 centimeters of darkened abdominal tissue that was 7-8 centimeters deep. The Defendant then sent the Plaintiff to a local hospital for a work-up of possible cellulitis.
On October 2, at 3:42 p.m., the Plaintiff was admitted to the hospital. Laboratory work was ordered along with a CT scan of the abdomen and pelvis without contrast. Laboratory work revealed an elevated white blood cell count with a left shift. CT scan showed multiple areas of dilated loops of small bowel with collapsed ileal loops suggestive of either a partial bowel obstruction or a post-operative ileus. The Defendant radiologist also reported severe anterior lower abdominal wall soft tissue changes with air noted in the subcutaneous tissues and small bowel noted to be adherent to this region. He was uncertain whether this represented post-operative changes or a perforated viscus and recommended a surgical consultation.
On October 3, the Defendant general surgeon, evaluated the Plaintiff, concluded that he had abdominal wall cellulitis, ecchymosis and dehydration and recommended continuation of antibiotics along with aggressive IV hydration. On October 4th, the Defendant surgeon noted that the patient had serosanguineous fluid draining from his wound and recommended continuing antibiotics and wound care.
On October 4, at 5:00 p.m., the Defendant GYN surgeon came to see the Plaintiff. She noted a large amount of fluid in the subcutaneous tissue and scheduled him for an irrigation of the abdominal wound. Prior to the irrigation, copious amounts of fecal matter were found exuding from the wound. A decision was made to take him for an exploratory laparotomy, inspection of the small bowel revealed at least 16-20 holes which were created by the liposuction procedure. The bowel was then run and several other small bowel holes were found on the mesentery and anterior mesenteric border of the small bowel.
The Plaintiff was then transferred to the Intensive Care Unit. On October 5th, the Plaintiff was transferred to the other hospital where he was given a colostomy. In addition, he has undergone several irrigation and debridements of his abdomen. On December 3rd, the Plaintiff underwent skin grafting from both of his anterior thighs to close his abdominal wound. The Plaintiff will undergo abdominal wall reconstruction in the future along with anticipated gastrointestinal difficulties.
The Plaintiff alleged negligent performance of the liposuction and negligent postoperative failure to timely diagnose the resultant multiple bowel perforations.