Articles Posted in Surgical Errors

We look to our surgeons in emergencies when we are in pain and need intensive medical attention. Surgeons must obtain written consent from the patient before any operation. The surgeon should fully explain the procedure and perform only what he or she explained to the patient.

Those steps were not followed in the case of T.P., who was awarded $2.397 million by a Cook County jury in a suit against Northwestern Memorial Hospital and Dr. Michael A. West, who performed surgery on her in 2006. T.P. underwent emergency surgery for treatment of cancer when all she actually needed was bed rest and antibiotics.

This case was reported in the July 13 edition of the Cook County Jury Verdict Reporter.
T.P. came to Northwestern Memorial Physicians Group complaining of flu-like symptoms on Aug. 14, 2006 following a recent trip to Jamaica. She was sent by ambulance to Northwestern Memorial Hospital, where she remained for 30 hours. Her condition improved there, but Dr. West, then the hospital’s chief of trauma surgery, decided she might have cancer based on what he considered an unusual appendix on a CT scan. He conducted no biopsy or pre-surgical work up and never told T.P. of his tentative diagnosis.

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It would seem to be a logical condition of surgery that surgeons first shave areas where the incision would be made. Many surgeons believe it is important to remove anything that would obstruct the place where the surgery takes place. Still other surgeons believe that shaving the area of the surgical entry spot will eliminate bacteria that can attach to hair.
In a recent article in the health section in the New York Times, it was pointed out that research now shows that shaving a patient’s skin before the surgery may actually raise the risk of infection.
According to the Centers for Disease Control and Prevention (CDC), surgical site infections have become a leading cause of complications among hospital patients. This would account for one of five of health-care associated infections. Thousands of deaths are associated with surgical site infections.

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Physicians should be aware that patients can use their smart phones or other electronic devices to tape alleged malpractice or negligence and introduce this evidence at trial. The presiding judge will determine whether the videotape may be presented.

Videotape, audiotape, and/or photographs can be introduced at trial if a proper foundation is laid and the subject matter is relevant, according to Robert Kreisman, JD, medical malpractice and personal injury attorney with Kreisman Law Offices in Chicago.
Kreisman was quoted in a recent issue of ED Legal Letter.

“To inform the jury, videotape could be introduced to give time and place. On the other hand, it depends on the quality of the videotape and what it depicts,” says Kreisman.

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In January 2007, J.F. underwent a splenectomy, which is the removal of the spleen, at the University of Illinois Medical Center at Chicago. J.F. had a condition known as idiopathic thrombocytopenic purpura (ITP), which is a blood disorder managed by steroid use. Reportedly more than two-thirds of the ITP patients who undergo a splenectomy achieve satisfactory remission to the blood disorder.

In this case, the attending surgeon opted to use the daVinci Robotic Surgical System, a minimally invasive surgical procedure, rather than a standard method of removing a spleen. Dr. Galvani, one of the co-surgeons, was assisted by a surgical fellow and a surgical resident. During the surgery, there was an incidental finding of severe liver cirrhosis, a disease of the liver.

Following the surgery, 49-year-old J.F. began showing signs of infection. The family alleged in their lawsuit that the surgeons punctured the duodenum during the surgical procedure. Six days later, Dr. Salti performed an exploratory laparotomy and discovered 1.5 liters of infectious pus inside the abdomen of J.F. But there was no detection of the hole.

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Often surgery is seen as a last resort in medical treatment; doctors usually turn to performing an operation only if no other option exists. This is because surgery itself is not only risky, but can also lead to a wide range of additional complications. Doctors often opt for the least invasive surgery possible in an attempt to minimize the risk of complications. However, the McHenry County surgical malpractice lawsuit of Douglas Andrews v. Marshall E. Pederson, M.D., et al., 05 LA 180, claimed that the defendant surgeon instead performed a more invasive surgery than was necessary.

The Illinois medical malpractice lawsuit was brought by the 59-year-old plaintiff against his surgeon and his medical group, Dr. Marshall Pedersen and Fox Valley Neurosurgery, Ltd., respectively. The plaintiff, Douglas Andrews, a former Illinois State Police trooper, claimed that Dr. Pedersen performed an unnecessary spinal surgery that resulted in additional back problems.

Mr. Andrews, had originally presented to Dr. Pedersen with a herniated disc that was radiating pain down his leg. Dr. Pedersen recommended that Andrews undergo an extensive spinal fusion surgery, which he then performed on Andrews. However, this type of surgery is often done as a last resort for persistent back pain. A spinal fusion involves permanently fusing together vertebrae, which not only limits a patient’s mobility, but can also lead to additional back pain because of the increased pressure put on the other areas of the spine.

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In a Cook County medical malpractice lawsuit, a patient’s surviving family members filed a medical negligence lawsuit claiming that the doctor had misdiagnosed the patient’s disease and elected not to properly treat it. However, a jury found in favor of the defendant doctor after determining that the doctor’s actions did not directly cause the patient’s death in The Estate of D.W., deceased, et al. v. Dr. Lee, Midwest Surgery, S.C., 11 L 79.

The decedent first met the defendant doctor after being admitted to Sherman Hospital with complaints of chest and abdominal pain in April 2003. Dr. Lee, a general surgeon, was brought in on consult after a CT scan did not return any clear or obvious cause for the patient’s pain; the CT scan only showed the presence of free air.
After reviewing the patient’s medical history, the doctors concluded that the pain was likely caused by a perforated duodenal ulcer located near the patient’s small intestine. Dr. Lee performed an emergency surgery to repair the perforated ulcer. A little over three weeks later, the patient was discharged from Sherman Hospital with orders to follow up with Dr. Lee in four days.

Everything seemed to be going well, until December 2003 when the patient returned to Sherman Hospital, this time with a diagnosis of cholecystitis and cholelithiasis, i.e. a bladder infection and gallstones. Once again, Dr. Lee was called as a consultant and ended up performing the surgery to remove the patient’s gallbladder. He was then discharged just four days after presenting to the hospital and was again instructed to follow up with Dr. Lee.

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A Lake County jury entered a verdict in favor of a woman who was sustained a head injury after falling from a surgical table. While the original medical malpractice lawsuit was filed against both the hospital where the fall occurred and the anesthesiologist who administered an epidural prior to the fall, the $790,860 verdict was only entered against the defendant hospital.

The 59 year-old plaintiff presented to Victory Memorial Hospital, now known as Vista Medical Center East, for treatment of a lower back injury. The plaintiff had injured herself after falling in a parking lot, sustaining not only the back injury, but a mild concussion as well. To help improve her pain, the plaintiff was given an epidural by Dr. Eliza Diaconescu, a pain management specialist.

According to testimony provided at the Lake County medical malpractice trial, the plaintiff remained semi-conscious after Dr. Diaconescu gave her an epidural. Dr. Diaconescu then walked away from the surgical table in order to dictate her treatment into the operative notes. An operating room nurse stayed with the plaintiff while she awaited her transfer to the recovery room. It was at this time that the plaintiff fell off the operating table, cutting her head and sustaining yet another concussion. The plaintiff filed a lawsuit against Dr. Diaconescu and Victory Memorial Hospital for their negligence in causing her injury.

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Despite testimony that a quicker response by a Cook County hospital’s staff could have increased a patient’s chance of survival by ten percent, a Chicago jury finds in favor of the defendant doctors and hospital. The Cook County medical malpractice lawsuit of Estate of Edward W. Dornhecker, deceased v. Dr. Robert E. Applebaum, SSM Regional Health Services d/b/a St. Francis Hospital & Health Center, 07 L 13665, was brought by the decedent’s family after he died of heart surgery complications.

In 2005, Edward Dornhecker underwent coronary artery bypass graph surgery at St. Francis Hospital, now called MetroSouth Medical Center, in Blue Island, Illinois. The surgery was performed by Dr. Robert Applebaum and all reports indicated that the surgery had gone well. However, the next evening, Dornhecker began to experience problems breathing. His oxygenation progressively worsened to the point that he needed to be intubated transferred to the ICU.
Upon his transfer to the ICU at 4:00 a.m., one of the nurses noted a foul-smelling, brown liquid coming from the decedent’s chest. The liquid was coming from the area from where a chest drainage tube had been removed the prior morning. The nurse called the on-call cardiologist and pulmonologist to report a “foul-smelling fecal matter” oozing from Dornhecker’s chest. However, it was not until Dr. Applebaum arrived at the hospital hours later that anything was done.

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In order to prove medical malpractice occurred, the plaintiff’s attorney needs to show not only the plaintiff experienced a poor medical outcome, but that it was directly caused by medical negligence. In the Kane County medical malpractice lawsuit of Melissa Nyquist v. Dr. Taras Masnyk and DuPage Neurosurgery, S.C., 06 L 421, the plaintiff’s attorney was unable to convince the jury that the plaintiff’s medical complications were caused by the defendants’ negligence.

The case facts centered on a spinal surgery the 34 year-old plaintiff had undergone at Central DuPage Hospital. Melissa Nyquist required a lumbar back fusion for a herniated disc at the L4-5 level. As part of the surgery, Dr. Taras Masnyk inserted four metal screws into the plaintiff’s spine. The screws were needed to stabilize the spine and fix the fused vertebrae in place.

However, following the spinal fusion, Nyquist began to experience foot drop in her right foot. A CT scan was taken to try and identify the underlying neurological problem that might be causing the new symptom. The radiology results showed that the surgical screw placed at the right L4-5 area had breached the medial wall and was actually extending into the spinal canal. And while the offending screw was removed the next day, Nyquist continued to experience right foot drop, along with lower back pain and sciatica, i.e. leg pain.

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Some people assume that whenever there is a negative medical outcome that it is the result of medical negligence. However, in some cases there can be a poor outcome without the presence of medical malpractice. Take for instance the Lake County medical malpractice lawsuit of Estate of Patricia Nickl v. Dr. Barry S. Rosen, 08 L 1015, where the jury found in favor of the defendant doctor.

The case of Nickl arose after the 64 year-old decedent, Patricia Nickl, died within days of undergoing surgery performed by the defendant, Dr. Rosen. Nickl had a longstanding history of abdominal and gallbladder problems and had already undergone four major abdominal surgeries. These prior surgeries were a significant piece of Nickl’s medical history because it increased the number of adhesions in her abdomen. Adhesions are bands of scar tissue that tend to form around surgical sites. Because the adhesions bond together areas that weren’t previously joined, they tend to complicate surgeries and increase the risk for perforations, or holes.

However, despite the large number of adhesions in Nickl’s abdominal cavity, she was still eligible for a laparoscopic cholecystectomy, i.e., the surgical removal of her gallbladder. The surgery itself was successful, but Nickl suffered from some post-operative complications. She remained hospitalized for several days longer than anticipated because of persistent pain and a lack of bowel movement.

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