Page 41 - Avoiding Surgical Mishaps Part 1

SVMIC Avoiding Surgical Mishaps: Dissecting the Risks

CASE STUDY

continued
transferred to the hospital where she had the original surgery
performed. During this hospitalization, the patient underwent

percutaneous drainage of the abscess and multiple insertions
and reinsertions of a nasogastric tube from which she was

receiving feedings. On February 7, she required an exploratory
laparotomy with a gastro-jejunostomy and placement of a

G-tube.

The patient developed multiple complications, including a

pleural effusion, wound infection, and chronic esophageal
stricture. Extensive hospitalization with antibiotics and total

parenteral nutrition were needed. The patient filed a medical
malpractice lawsuit alleging that the surgeon failed to

communicate to the covering physician that the pending CT
scan must be reviewed before discharging the patient from

the hospital. As a result, the gastric outlet obstruction was
not diagnosed and treated in a timely manner. Because of

this delay, the patient experienced significant reflux of gastric
acid into her esophagus over a lengthy period of time. This

led to the numerous complications, additional surgery, and
the chronic esophageal stricture, which now requires her to

undergo repeated esophageal dilatations.

Although the indications for surgery were appropriate and the

informed consent was done well, during depositions it was

learned that the CT scan was done Friday, and the surgeon
left town for the weekend without reviewing
the results. There was no indication that he

made his covering partner aware of the CT,

nor did he explain that the results needed to
be reviewed prior to discharging the patient.

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