Page 17 - 2022 Risk Basics - Surgical Practice

SVMIC Risk Basics: Surgical Practice

another post-op assessment. He also saw his primary care

physician that week and a chest x-ray identified a left
pleural effusion, so a CT scan was ordered to investigate

further. The CT found a large loculated collection of fluid in

the left-upper quadrant of the abdomen, causing
displacement of the spleen and kidney. He was admitted

to the hospital on June 7, and 5 L of clear, yellow fluid with
a PH of 7.46 was drained from the cystic area identified by

the CT scan. A urologist was consulted, and a ureteral

injury was diagnosed. The patient underwent a series of
operations to drain a uroma, insert a nephrostomy tube,

and address a left mid-ureter repair. In November, an
incisional hernia was also found which required surgical

correction. The patient was unable to begin chemotherapy

until March of the next year because of the complications
and operations. The plaintiff filed a lawsuit citing that the

injury to the ureter was not a part of the body directly or
proximately related to the colon resection surgery.

Because the surgeon utilized a generic consent form

which did not allow for the addition of specific risks or
potential complications for the particular operation being

performed, there was no evidence that the patient had
been given a full understanding of the potential risks of this

operation. Instead, the form indicated that the patient was

consenting to “the procedure” and that there were risks
associated with the procedure. In this type of operation,

there is a known risk of a ureteral injury which should have

been discussed and included as part of the consent
documentation, either on the form or in the office visit

notes.

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