Was bowel perforation surgical or spontaneous?
<court>US District Court, Western District of Tennessee</court>
A woman was discharged 4 days after a total abdominal hysterectomy and oophorecto-my, during which dense adhesions were encountered between the bowel and left ovary. Six days later she presented to the emergency department with complaints of abdominal pain and stool problems. A CT scan showed accumulation of free gas.
Immediate exploratory surgery revealed a 2.5-cm perforation of the bowel that was repaired. Several more surgeries were required because of massive fecal contamination, including a partial colectomy and a temporary colostomy.
In suing, the woman faulted the surgeon for injuring the bowel and failing to recognize the injury. She maintained that prompt discovery of the injury would have minimized complications.
The defense claimed that the bowel had spontaneously perforated within a day of the repair surgery, and showed pathology slide evidence of a recent event.
- The jury returned a defense verdict.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, Nashville, Tenn (www.verdictslaska.com). The available information about the cases is sometimes incomplete; pertinent details may be unavailable. Moreover, the cases may or may not have merit. Still, these cases represent types of clinical situations that may result in litigation and are meant to illustrate variation in verdicts and awards.