Did injury at cystectomy lead to need for dialysis?
<court>District of Columbia Superior Court</court>
While removing a large cyst from a 46-year-old diabetic woman, a physician feared he may have cut or ligated the patient’s right ureter. Based on an indigo carmine dye test, however, he determined the ureter remained undamaged.
In the days following the procedure, the patient began to experience back pain, blood in the urine, nausea, fever, elevated creatinine, and other signs of ureteral damage. The physician, however, waited 8 days before consulting with a urologist, who concluded the patient had an obstruction of the right ureter.
Surgery 4 days later revealed the injury was beyond repair, and the patient’s right ureter and right kidney were removed. In the following months, the woman’s overall kidney function declined sharply, and she was ultimately placed on dialysis.
In suing, the woman claimed her physician did not properly assess the status, location, and integrity of the right ureter, and did not appropriately address her postoperative symptoms. She further claimed that the injury accelerated her need for dialysis and thus shortened her life expectancy by 6 to 7 years.
The doctor argued that he did not violate the standard of care, and that the woman’s preexisting renal condition, not the injury, created the need for dialysis. He maintained that the patient’s noncompliance with previous recommendations and a lack of more aggressive medical treatment were also, in part, to blame for the injury.
- The case settled for $3 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.