Articles Posted in Surgical Errors

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Doe, who was born with the congenital heart defect tetralogy of Fallot, underwent surgery to repair the defect when he was an infant. Various echocardiograms during his childhood revealed a small hole in his atrial septum.

Tetralogy of Fallot is a congenital heart condition that involves four abnormalities occurring together, including a defective septum between the ventricles and narrowing of the pulmonary artery; it is accompanied by cyanosis.

At age 10, Doe underwent surgery to repair his pulmonary valve. Dr. Roe placed Doe on cardiopulmonary bypass but did not cross-clamp the aorta, which allowed air to pass from the right side of Doe’s heart through the atrial septal defect to the left side of Doe’s heart.
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Ms. Doe, 63, underwent a hysterectomy performed by Dr. Roe. Almost three weeks after the procedure, she was admitted to a hospital where testing showed that she had a gangrenous cecum.

Ms. Doe underwent two colectomy surgeries, was hospitalized for three weeks and required a month of inpatient rehabilitation.

Ms. Doe now suffers from chronic abdominal pain but is not a candidate for reversal of her colostomy. In addition, she requires daily in-home assistance.
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Mr. Doe, a diabetic who suffered from peripheral vascular disease, underwent a partial leg amputation. While undergoing inpatient rehabilitation, Mr. Doe developed symptoms of a gastrointestinal bleed and was readmitted to the hospital.

During Mr. Doe’s 5-day stay, his attending medical providers did not assess his surgical stump and nurses did not change his dressing.

Mr. Doe developed an infection of the incision site, resulting in gangrene. Consequently, Mr. Doe required a revision of the surgical stump. He sued the hospital alleging improper wound treatment.
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Daniel Scavetta, who had a history of intravenous drug abuse, began seeing internist Dr. James Agresti. Dr. Agresti prescribed Suboxone. After a colonoscopy revealed multiple polyps, including one that was too large to remove, Scavetta was referred to a colorectal surgeon, Dr. Joel Nizen.

A CT scan showed a 1.9 cm lesion in Scavetta’s liver and an enlarged spleen. This prompted the interpreting radiologist to recommend that Scavetta undergo an MRI of his abdomen. Although Dr. Nizen performed surgery approximately two weeks later, he did not investigate the lesion.

Approximately 13 months later, Scavetta saw blood in his urine. The CT scan and MRI revealed a 4.2 cm liver mass. Scavetta was subsequently diagnosed with having Stage IV hepatocellular carcinoma.
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Ms. Doe, 41, underwent a laparoscopic hysterectomy that was performed by Dr. Roe, an obstetrician. During the procedure, Dr. Roe discovered that a morcellator was unavailable and that the doctor could not complete the surgery as she had anticipated. A power morcellator is a surgical tool that surgeons use to cut bigger chunks of tissue into smaller ones usually during laparoscopic surgery. Surgeons use this tool mainly in gynecological procedures such as laparoscopic hysterectomy, as in this case.

Dr. Roe then bivalved Ms. Doe’s uterus manually and finished the surgery. Ms. Doe experienced postoperative sepsis and peritonitis.

An exploratory laparotomy revealed that Ms. Doe had a perforated bladder, small intestine, and rectosigmoid colon, as well as an injured urethra. A laparotomy is a surgical procedure with small incisions to the abdominal wall to gain access into the cavity.
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Thomas Lapsley went to a nearby hospital emergency room where doctors ordered a CT scan of his abdomen and pelvis. The scan revealed a lesion on his liver. A follow-up liver CT scan was ordered to rule out metastatic disease. There was nothing in the report as to the symptoms Lapsley might have experienced that prompted him to go to the emergency room.

After the CT scan, a surgeon, Dr. Ben Davis, did an exploratory laparotomy and repaired Lapsley’s gastric ulcer.

Over the next week, as Lapsley was admitted to the hospital, he did not undergo further evaluation of the liver mass and allegedly was not informed of the mass at his discharge. Eighteen months later, another doctor referred him for yet another CT scan. That scan led to a diagnosis of Stage IV metastatic cancer. Sadly, Lapsley died just one month later.
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Elizabeth Njinga suffered from back pain for a long period of time. She was referred to an orthopedic surgeon, Dr. Michael Alexiades. The doctor reviewed her x-rays and ordered an MRI.

Dr. Alexiades told Njinga that she had moderate degenerative changes in her hip and that her pain was coming from her hip and her back. The doctor recommended a hip replacement for pain relief.

After undergoing that surgery, Njinga experienced continued pain. Her relationship with her husband has been affected, and she is unable to travel extensively as she once did because of her condition.
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Mr. Doe, age 55, underwent surgery to repair a ruptured tendon in his right bicep. After the surgery, he complained to Dr. Roe, the surgeon, that he had numbness and tingling and could not feel his right hand.

Dr. Roe ordered an x-ray and allegedly told Mr. Doe that a nerve had been irritated during the surgery; he said this condition would improve in time.

However, several weeks later, Mr. Doe consulted a hand surgeon. Mr. Doe underwent exploratory surgery with the second surgeon, which revealed that the metal “button” used to anchor Mr. Doe’s tendon to the bone had entrapped the posterior interosseous nerve (PIN). Although the metal button was removed by the second surgeon, Mr. Doe suffered permanent nerve damage. This resulted in permanent pain and numbness as well as a lost function in his right hand. Mr. Doe was an accomplished piano player but is now unable to continue playing.
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Mr. Doe, a 59-year-old carpenter, suffered from myocarditis. He was placed on the United Network for Organ Sharing (UNOS) heart transplant list.

Myocarditis is an inflammation of the heart muscle. The condition can affect the heart muscle and the heart’s electrical system, reducing the heart’s ability to pump. It can cause rapid or abnormal heart rhythms (arrythmias).

In many cases, myocarditis is caused by a viral infection. A severe case can weaken the heart, which can lead to heart failure, abnormal heart rate and sudden death. Under these circumstances, a heart transplant may be necessary.
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Almost seven years into this lawsuit, after discovery had been closed and with a summary judgment deadline looming, the defendants in this case, Dr. Partha Ghosh and Wexford Health Sources Inc., raised the affirmative defense of res judicata for the first time. This was an unexpected motion to dismiss an amended complaint. When the plaintiff, Alnoraindus Burton, responded that the defense had been waived or forfeited, while the defendants argued that the 7th Circuit Court of Appeals opinion in Massey v. Helman, 196 F.3d 727 (7th Cir. 1999), required a district court to allow any and all new affirmative defenses whenever a plaintiff amends a complaint in any way. The district court judge in this case agreed with that decision and granted the defendants’ motion to dismiss.

In this appeal, the 7th Circuit reversed and remanded the case. The court stated that the standard for amending pleadings under Federal Rules of Civil Procedure 8(c) and 15 continues to govern the raising of new affirmative defenses even when an amended complaint is filed.

This appeals panel stated that Massey held that a defendant is entitled to add a new affirmative defense prompted by an amended complaint that changes the scope of the case in a relevant way. Massey does not, however, require a district court to allow any and all new defenses and response to any amendment to a complaint, without regard for the substance of the amendment and its relationship to the new defenses. Rather, a district court must exercise its sound discretion under Rules 8 and 15 in deciding whether to allow the late addition of a new affirmative defense.
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