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Medical Malpractice Case Report: Over $1.9 Million for Failure to Timely Diagnose and Treat a Postoperative Complication
Firm Partner Peter A. Schmit succeeded in obtaining a $1,920,000 settlement in a medical malpractice case involving a failure to timely diagnose and treat a postoperative complication in a 53-three-year-old man. Read the following Minnesota Case Report, Vol.29, No.2, November, 2010.
(Excerpts taken with permission from Minnesota Trial Lawyer Association’s (MTLA) “Minnesota Case Reports”)
D.B., a 53-year-old construction supervisor, was admitted to a small rural hospital in August of 2007 for a laparoscopic cholecystectomy. Dr. P., a family practice physician, performed the procedure and documented some "difficulty" during the procedure with adhesions and ascertaining anatomy. Postoperatively, D.B. demonstrated an abnormally elevated white blood count and abnormally low urine output. D.B. was discharged. D.B. returned to the clinic the following morning and saw Dr. P. with the complaint of extreme abdominal pain and shortness of breath. Dr. P's diagnosis was constipation. D.B. was then admitted to the local hospital for observation and Dr. P. offered Fleet enemas. Dr. P. did not order routine monitoring of intake and output and he did not order frequent monitoring of D.B.'s vital signs. Dr. P. did not acknowledge nor act on the decreased urine output, severely concentrated urine, significant abdominal pain, poor oral intake and abdominal distension. Throughout the day on 8/24/07, Dr. P. ignored the ongoing evidence of an acute abdomen. Later, on 8/24/07, bile was noted on D.B.'s gown and the staff documented that he was pale and diaphoretic. D.B.'s condition deteriorated and eventually Dr. P. took him back to surgery. At this time, he was critically dehydrated. During intubation, aspiration took place. During surgery Dr. P. found peritoneal fluid from a bile leak which he described repairing.
Eventually, Dr. P. contacted a tertiary care center where he was admitted with adult respiratory distress syndrome, peritonitis and multi-system organ failure. D.B. required extensive resuscitative efforts, renal care, surgical care to relieve abdominal compartment syndrome, infections disease care for cellulitis and a subsequent MRSA that developed and plastic surgery care for an extensive defect in the abdominal wall. D.B. was hospitalized for several weeks requiring follow-up care at the Mayo Clinic for ongoing wound care and plastic surgery care. D.B. required TPN feeding for approximately three months and was out of work for approximately a year and a half. Fortunately, D.B. has recovered such that he has returned to work full time in a new position but still has limitations due to his prolonged sickness, a permanent weightlifting restriction and likely will require additional plastic surgery to deal with the abdominal wall defect.
Plaintiff's Expert: Board certified surgeon with additional expertise in surgical quality of care and surgical credentialing, opined that Dr. P. departed from accepted standards of medical practice in failing to timely recognize the operative complication, failing to recognize deterioration in D.B.'s situation, failing to timely refer D.B. to a biliary repair specialist, failing to aggressively resuscitate D.B. thereby allowing D.B. to go into multi organ system failure and raised questions regarding the appropriateness of a family practice physician performing a biliary repair surgery.
Prior to commencing suit, the claim settled for $1.920,000 out of $2,000,000 available coverage on a Pierringer basis thereby preserving any and all potential claims against the hospital.
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