Page 29 - 2022 Risk Basics - Surgical Practice

SVMIC Risk Basics: Surgical Practice

also ordered a CT scan and then handed off care to

another physician in the practice as he was going on
vacation. At the time that he handed the patient’s care over

to the covering physician, he had not yet received the

results of the CT scan and forgot to mention to that
physician that he needed him to review the results before

allowing the patient to be discharged home. Two days
later, the covering physician determined that the patient

had made good progress with her diet and was able to go

home on pain medication and Reglan. He wrote the order
for the prescriptions and the discharge, without ever

seeing the CT that the surgeon ordered which showed a
persistent gastric outlet obstruction that required further

treatment. The patient was discharged home on January

19, post-op day eight.

On January 21, the patient was admitted to a different

hospital with severe abdominal pain, nausea, and

vomiting. Bowel sounds were diminished, and labs were
abnormal. On January 22, 11 days after the gastric

resection, a CT scan showed significant gastric outlet
obstruction and the development of an abdominal

abscess, so the patient was 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.

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