Chronic pelvic pain: entrapped nerve or endometriosis?
<court>Tompkins County (Ny) Supreme Court</court>—A woman presented to an internist with transient right-sided abdominal pain that propoxyphene did not alleviate. A CAT scan and sonogram showed a right adnexal mass.
The internist referred the patient to a gynecologist, who could not assess rebound pain because her abdomen was too tender. Since the woman was in extreme pain, he also could not perform a pelvic exam. He admitted her to the hospital with a prescription for intravenous meperidine. When the pain persisted, the clinician performed a laparoscopy and found adhesions between the ovary and abdominal wall. After lysing them, he diagnosed endometriosis and removed the ovary. Although the patient’s right-sided pain was alleviated, she suffered left-sided pain postoperatively. A pain management doctor diagnosed an entrapped nerve, and the woman underwent 2 surgeries to lessen the pain.
The plaintiff claimed the gynecologist performed the laparoscopy prematurely.
The patient sued the gynecologist, contending that she still suffered abdominal pain and that the gynecologist prematurely performed the laparoscopy. She also stated that he entrapped the left branch of the inguinal nerve when he closed the trocar incision. The physician argued the surgery was performed according to the standard of care.
The jury returned a defense verdict.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.