Articles Posted in Surgery Malpractice

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Each year, our law firm receives several requests to review medical malpractice cases involving the removal of the gallbladder to treat gallstones. We typically pursue one to two of these cases per year.

The procedure allows for bile to bypass the gallbladder on its way out of the liver. Bile is a substance created in the liver and used for digestion of food in the small intestine. Bile normally flows from the liver down the right and left “hepatic ducts” into the “common hepatic duct” and is stored in the gallbladder until it is needed for digestion. When gallstones form in the gallbladder – a condition known as “cholelithiasis,” – they can interfere with the normal flow of bile and disrupt the digestion process. This can be a very painful and debilitating condition.

To treat and remove the gallstones, doctors often recommend that the patient undergo a “laparoscopic cholecystectomy,” which is the removal of the gallbladder through minimally invasive surgery. During a laparoscopic cholecystectomy, the gallbladder is removed and then the bile flows directly from the liver through the right and left hepatic ducts and then into the small intestine.

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Surgery sometimes is necessary for patients who have an injury or medical condition that less invasive treatments cannot help. However, surgery is not always the appropriate measure in every situation, and if a doctor performs unnecessary surgery, patients may suffer a number of medical problems as a result.

A recent USA Today review of government records and medical databases found that tens of thousands of times each year patients are wheeled into the nation’s operating rooms for surgery that is not necessary. The study found that some providers do so just to take advantage of insurers or Medicare to drain them of funds, and some surgeons and doctors lack the competence and training to know when procedures are not necessary. Other times the facts don’t call for a surgery, or alternative treatments would have remedied the problem just as effectively.

A largely hidden problem, the study reported that unnecessary surgeries might account for ten to twenty percent of all operations in some specialties, particularly cardiac and spinal procedures. Knee replacements, hysterectomies, and cesarean sections were among the other surgical procedures performed more often than needed, according to the review. The study also analyzed the U.S. government’s National Practitioner Data Bank public use filed, which tracks medical malpractice suits. Since 2005, the newspaper found, more than 1,000 doctors have made payments to settle or close malpractice claims in surgical cases that involved allegations of unnecessary or inappropriate procedures. About half of these payments involved allegations of serious permanent injury or death, and many of the cases involved multiple plaintiffs, suggesting hundreds, if not thousands, of victims.

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Severe and permanent nerve injuries due to medical malpractice unfortunately can occur. These cases can be challenging to win because there often is not clear evidence of exactly how the nerve injury occurred. Recently, I successfully concluded a case of a nerve injury that allegedly was caused by malpractice. That case involved a severed sciatic nerve which occurred during orthopedic surgery. The surgeon denied that he severed the nerve; however, the patient walked into the hospital on the morning of the surgery and woke up with the severed nerve.

Nerve injury cases also can be very challenging because the extent of nerve injuries can be hard to quantify objectively. In my experience, defense attorneys and insurance adjusters tend to be suspicious of plaintiffs who have nerve injuries because the pain caused by these injuries is subjective and, therefore, hard to objectively quantify.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving nerve injuries. They are extremely complicated and require expertise that most general personal injury attorneys do not have. To see some of the cases I have handled, click here.

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In 2007, an active lieutenant with his local Sheriff’s Department made the decision to undergo weight-loss surgery. At 6-foot-1 and 375 pounds, the risk of a routine laparoscopic gastric bypass surgery seemed slight compared to his many weight-related health risks. Then suddenly, the day after the procedure, he went into respiratory failure and had to be placed in critical care. For over a week, he showed signs of complications but doctors did not take him back into surgery to repair the problem for eight days. This was a serious medical error, even based on the testimony of the hospital’s own experts who admitted that most bariatric doctors would have performed the surgery as soon as the patient exhibited the symptoms, but certainly no later than six days after.

As a result of the delay in treatment, the patient’s blood pressure dropped and he experienced a “low-flow stroke,’ meaning his brain was not getting enough blood, causing him to remain comatose for two weeks following the surgery. Then, in another shocking medical mistake, doctors failed to give him eye drops while he remained on a respirator which resulted in a permanent loss of his eyesight. This avoidable complication was a clear breach of the standard of care.

The man’s family filed a medical malpractice suit against the hospital alleging medical negligence and fraud. Now brain damaged and confined to a wheelchair, this once active lieutenant has lost his ability to speak, walk and perform basic tasks such as feeding or bathing himself, but he understands what has happened to him. The family’s attorney insisted that this tragic outcome was the result of improper care by an inexperienced doctor. Specifically, the hospital advertises that its bariatric surgeons have performed upwards of fifty surgeries when, in fact, this man’s surgeon had performed only about twenty.

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The Rhode Island Health Department has fined a Rhode Island Hospital $150,000, after finding that a surgical team committed medical malpractice and violated patient safety policies when it operated on the wrong finger of a patient. According to the Health Department, the surgical team failed to properly mark the fingers and failed to follow the rules for “time out.” A time out is a pause before surgery to verify the patient, procedure and operative site. The finger incident was the fifth wrong-site surgery at the hospital since January 2007.
The Health Department reprimanded the hospital, required observation of every surgery for one year, required full adoption of a statewide surgical protocol and required installation of video and audio recording in every operating room. A copy of the article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have only handled one case of wrong site surgery. I believe that most of the medical malpractice attorneys in Baltimore have not handled any such cases, as these cases are extremely rare. I can understand one case happening in a hospital over the course of several years, but 5 cases in the same hospital in 2 years. That place should be shut down. There is no defense to operating on the wrong surgical site over and over. It is medical malpractice, plain and simple

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A Massachusetts jury has found that two doctors at Children’s Hospital Boston were guilty of medical malpractice that caused the death of a 3-year-old boy, and awarded the parents $15 million. The boy died a year and a half after he underwent surgery for a birth defect. The child was born with a severe congenital heart defect called Tetralogy of Fallot, a complicated but treatable birth defect that affects the flow of blood through the heart. He underwent eight procedures, 7 of which were cardiac catheterizations, before coming to Children’s for another catheterization procedure to widen his arteries. After the Boston procedure, the child suffered a seizure. A CAT scan revealed that that contrast dye, which is used during the procedure to better see the patient’s anatomy, had leaked into his brain. Later, an MRI revealed that a piece of metal had lodged in the boy’s brain, probably from a medical instrument. When the child left the hospital, he was unable to walk or speak. The jury awarded damages of $5 million for the child’s pain and suffering, $5 million for the parents’ loss of their child, and $5 million for the child’s wrongful death. A copy of the article regarding the case can be found here.

According to the lawyers involved in the case, the parties reached a “high-low” settlement prior to the jury’s verdict. Such settlements can be structured in many different ways, but usually it means that the plaintiff will get a certain amount of money guaranteed (the low) in exchange for agreeing that no matter how high the verdict is the defendants will not have to pay more than a particular amount (the high). Usually, the plaintiff gets the low even if he/she loses the case. But sometimes the settlement agreements are structured so that the defendant only pays the money if the plaintiff wins the case. If the verdict is between the high and low, then the plaintiff gets that amount. These agreements can be beneficial to both sides to protect each side from their worst case scenario – in other words, it protects the plaintiff from losing the case completely and it protects the defendant(s) from a large verdict.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving sick children, and have done a number of high-low settlements. They are extremely complicated and require expertise that most general personal injury attorneys do not have. To see some of the cases I have handled, click here.

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There has been a lot of publicity lately about a doctor at St. Joseph Medical Center in Towson, Maryland, that supposedly implanted cardiac stents that may not have been necessary. The publicity started after St. Joseph Medical Center sent out letters to 369 former patients stating that a review of surgeries by Dr. Mark Midei revealed that Dr. Midei may have told these people that they had severe coronary artery blockages that they actually didn’t have, and then recommend and performed stent surgery on these people when it was not necessary. Usually, such stents are only placed in people who have blockages of 70% or more. A copy of the article regarding this issue can be found here.

In the article, a women is quoted who was told that she had a 90% blockage and underwent stent surgery as a result, but after getting a letter discovered that she only had a 10% blockage and didn’t need the surgery. Not only did she undergo unnecessary surgery, but she incorrectly believed she had severe cardiac disease and now has to take blood thinners for life due to the stent.

There are clearly a lot of unanswered questions here. Who was reading the heart scans and incorrectly interpreting / reporting on them, why did Dr. Midei not pick up on this, why did St. Joseph Medical Center not pick up on this earlier, were there financial incentives for any of these parties that gave them incentive to do this, etc.

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One common type of malpractice concerns the failure of a clinician or radiologist to properly diagnose a patient’s musculoskeletal tumor based on the relevant clinical and radiological features. One sub-type of these musculoskeletal tumors is a cartilage tumor, a tumor that grows within a human bone.

Musculoskeletal tumors are benign or malignant lesions that form in human bone and the connective tissues. Cartilage tumors are musculoskeletal tumors that produce cartilage inside the host bone. There are only two types of cartilage tumors: enchondroma (benign) and chondrosarcoma (malignant). Cartilage tumors range in severity from benign enchondroma to low-grade malignant chondrosarcoma to high grade chondrosarcoma. Chondrosarcoma is the second most common primary malignant bone tumor, accounting for 25-30% of all primary bony malignancies.

Several well-established clinical guideposts and principles exist regarding location, size, presence and duration of pain, and age of the patient, that assist physicians in distinguishing a benign enchondroma from a low-grade malignant chondrosarcoma. Clinically, benign enchondromas most commonly involve the tubular bones of the hands and feet. When present in long bones, such as the femur, enchondromas most often are located in the distal femur (furthest from the hip). Enchondromas are usually asymptomatic; i.e., with no associated pain, and therefore, the vast majority are discovered incidentally on radiographs or bone scans done for other reasons. The majority of enchondromas are approximately 3 cm in maximum dimension. Benign tumors larger than 5 cm in maximum dimension are extremely rare. In contrast, chondrosarcomas are most commonly located in the proximal femur (closest to the hip) and pelvis. Like other malignant tumors, the single most common clinical symptom for chondrosarcoma is the presentation with pain that is directly referable to the bone in which the tumor is growing. Published literature indicates that the pain is typically present for 1-2 years prior to diagnosis and is most often described by patients as an insidious or achy pain that is initially constant in nature, but that ultimately progresses in severity. Generally, patients with chondrosarcoma are over the age of 40, while those with benign enchondroma are typically under the age of 40.

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A widower has won an $8.5 million medical malpractice verdict against an Indiana hospital over his wife’s death. The woman, who had a dangerous bowel obstruction, died after the hospital failed to timely get an x-ray to doctors that showed her condition. During the trial, the man’s lawyers presented evidence demonstrating that the hospital failed to promptly get an x-ray to doctors that revealed the bowel obstruction, which is a life-threatening medical condition. The Plaintiff alleged that the hospital’s actions led to a one day delay in reading the film and postponed emergency surgery that would have cleared the obstruction and saved the woman’s life. A copy of the article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled several bowel cases arising from negligence. Some have been mesenteric ischemia malpractice cases and others have been bowel obstruction malpractice cases. Time is of the essence in treating such a condition, and timely communication among the health care providers is essential. To see some of the cases I have handled, click here.

In this case, an interesting point is that the verdict will be reduced from $8.5 million to about $1.25 million due to a cap on damages in Indiana. Maryland also has a cap on damages. In Maryland, the current law, which can be found in section 3-2A-09 of the Courts and Judicial Proceedings Article of the Annotated Code of Maryland, which states:

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A jury has awarded $1 million to a New Mexico man who alleged a surgeon committed medical malpractice in repairing a colon perforation after a colonoscopy. The patient suffered a tiny bowel perforation during a colonoscopy. The surgeon then operated in order to repair the hole, but the surgeon did not see any hole and therefore failed to repair it. Because the surgeon didn’t see the perforation, he assumed it had sealed itself, but the surgeon failed to use procedures he could have used – such a dye test – to locate the perforation. As a result, the man’s bowels continue to leak feces into his man’s abdomen for eleven days causing massive infection. The infection resulted in severe scarring in his abdomen, which has required thirteen operations.

As an experienced Baltimore, Maryland medical malpractice lawyer, I frequently handle medical malpractice cases in Baltimore, Maryland and other places involving surgical mistakes. To see some of the cases I have handled, click here .

In a case like this, it is important to know that causing a perforation during a colonoscopy usually is not negligence. But failing to timely recognize the perforation and quickly fix it can cause catastrophic injuries due to infection and post-recovery complications, just like in this case.