John was involved in a car wreck and suffered a neck injury. After his initial recovery, John noticed he was having difficulty buttoning his shirt and picking up small objects such as coins. When he questioned his doctor, a neurosurgeon, John was told a ruptured disc in his neck was pressing against nerves and causing a loss of his fine motor skills. The surgeon recommended John have the ruptured disc removed and replaced with a bone graft. The graft would be held in place by a small rectangular titanium plate and four (4) tiny screws. John agreed to have the surgery, which involved an incision on the right side of his neck, cutting through the muscle and shifting the esophagus out of the way so as to expose the spine, then removal and replacement of the disc with a graft. John was told the procedure went well and was a complete success.
Several days after surgery, John noticed an annoying tickling sensation in his throat. It caused him to cough and try to clear his throat and eventually grew worse. When John developed a fever and chills, the surgeon told him he probably just had a cold and advised him to take Tylenol. John began to cough more frequently and he felt terrible all the time. He called his surgeon on several occasions but was always told to keep taking the Tylenol and get plenty of rest.
Four (4) weeks after the surgery, John was sitting at home one Saturday morning watching television and he had a violent coughing spell. He covered his mouth as he began to cough and felt something fall into the palm of his hand. When the coughing spell stopped, he looked into his hand and found one of the screws which had been placed in his spine four weeks earlier. Frantic, John called his surgeon but could not reach him. The surgeon’s partner advised John to come back to the hospital immediately. John’s wife helped him into their pickup truck and drove him to the hospital. By the time they arrived, John could not move his legs. He was unable to walk into the emergency room. John was rushed to surgery immediately. He awoke four days later to find himself completely paralyzed from his mid-chest down. He had lost the use of his dominant right hand and arm and had only limited use of his left hand and arm. Because of errors by his original surgeon, John would spend the rest of his life as a C-6 quadriplegic. A self-employed business man and father of two (2) infant children, John would be in a wheelchair for the rest of his life. He would never walk again, never have a normal relationship with his wife, and he would require twenty-four (24) hour a day nursing care. Eighteen (18) months after he became a quadriplegic John’s wife divorced him, and took their two (2) children. John now lives with his nursing staff who care for him day and night.
Suit was filed against the neurosurgeon who performed John’s original disc removal and fusion as well as the manufacturer of the plate and screw system which was used in his surgery. Experts retained on John’s behalf testified the surgeon had stripped one of the screws as he put it in and he should have removed and replaced it with a larger “rescue” screw instead of leaving it in the plate hoping the fusion would heal without further incident. Engineering experts who reviewed the design of the plate and screw system found that it lacked a simple safety feature which would have prevented the screw from backing out. Collectively, experts retained on John’s behalf testified that following his discharge from the first surgery, the stripped screw began to work its way out of the plate every time John spoke, swallowed or coughed. As the screw backed out, it pressed into the edge of John’s esophagus, eventually causing a hole in the esophageal wall. The hole became an entry point and caused an infection to set up in John’s spinal cord, literally crushing the spinal cord and causing his paralysis.
After two and a half (2½) years of investigation and trial preparation, the case was mediated and the surgeon and screw manufacturer settled for Three Million Dollars ($3,000,000.00). The car wreck which caused John’s injury was settled for Nine Hundred Seventy-Five Thousand Dollars ($975,000.00). Since John was performing work-related duties at the time of the car wreck, he was deemed to be eligible for workers’ compensation benefits which paid all of his medical expenses to date, as well as all of his future medical expenses, including handicap accessible vans, a specially equipped home, and nurse staffing to remain with him for the rest of his life. To date, John has received money and benefits in excess of Eight Million Five Hundred Thousand Dollars ($8,500,000.00).
(FAILURE TO SUPERVISE NURSING STAFF)
Kathy suffered from psoriasis, a chronic skin disease which caused thick, red patches and dry silvery scales to appear on her face, elbows, knees, palms and soles of her feet. Psoriasis is believed to be a condition which occurs when the immune system does not work properly. Kathy sought help from a dermatologist who prescribed phototherapy treatment. During phototherapy, the patient’s skin is exposed to ultraviolet light. Kathy received her treatment in the dermatologist’s office in a large “light box” where she would sit after she had removed all of her clothing. Kathy was prescribed weekly treatments of exposure to Ultraviolet Light A (UVA).
Over the next eight weeks, Kathy went to her dermatologist’s office, checked in with the nurse who, after Kathy undressed, placed Kathy in the light box, increasing the amount of time Kathy spent from five to thirty minutes as her tolerance increased. During the first seven visits, Kathy showed no improvement. When she went for her eighth visit, the nurse was not present and Kathy’s dermatologist escorted her into the light box and set the controls. After a few minutes, Kathy remarked her skin was tingling and it felt like the light was doing some good for the first time. After ten minutes, Kathy advised her dermatologist she was beginning to feel “a little bit sun burned”. After eighteen minutes, Kathy asked to be taken out of the box because her skin felt like it was on fire and she was about to pass out. The dermatologist turned off the light, open the light box door to find Kathy appearing sun burned. Kathy was told to contact the doctor if her condition did not improve over the next few hours.
After she left her doctor’s office, Kathy’s skin burned so badly she could hardly stand her clothes. She arrived at home and felt like her skin was on fire. Kathy removed her clothes and found, to her dismay, huge blisters were forming all over her body. Kathy called her husband who took her to a local hospital where she was admitted and treated for second degree burns over eighty percent of her body. It was a month before Kathy was able to return to work.
Suit was filed against Kathy’s dermatologist for failing to properly monitor her phototherapy and allowing her to suffer second degree burns. During trial preparation it was discovered the dermatologist’s nurse had been setting the light box to administer ultraviolet B (UVB) instead of UVA. Since UVB is substantially different from UVA, Kathy had not developed the tolerance required for an extended period of exposure to UVA. The case was eventually settled for a confidential sum.
Eighty-four year old Katrina was an active and vibrant senior who enjoyed playing bridge, attending church and going for daily walks. Katrina developed a mild bleeding ulcer which would occasionally flare up and require a day or two of treatment at her local hospital. On her last hospitalization, Katrina was sitting up in bed chatting with her daughters when a nurse came in and administered the prescription medication ordered by her treating physician earlier that morning. As the nurse left her room, Katrina began to gasp for breath, she looked at her daughters and said “my God, they’ve given me something and its killing me”. Her daughters called for the nurses who rushed in and tried to revive Katrina. She died while her daughters looked on.
An autopsy revealed that Katrina’s blood had at least twenty times the normal dosage of a certain medication utilized to treat her condition. We obtained experts, including the County Medical Examiner, who testified the overdose of medication caused Katrina’s death. Suit was filed against the hospital and after twelve months the case was settled for a confidential sum.
Seventy-two year old Dottie awoke Saturday morning with a dull pain in her stomach. It was still hurting when her husband got out of bed. He took her to a local hospital emergency room and the ER physician saw her at 9:00 a.m. The ER doctor admitted her to the hospital and advised the hospital to keep her under observation and notify Dottie’s internist to come and check her by 10:00 a.m. that morning.
Dottie was put into a room by the hospital staff and her internist was called. The internist was involved in outside activities and told the hospital staff it didn’t sound serious at that time, but to please keep her posted if Dottie’s condition changed. Over the next thirty-five hours, the hospital called and left messages on the doctor’s voicemail describing an increase in Dottie’s temperature and more pain in her abdomen. The last several calls were made by the head nurse who was concerned that whatever was causing Dottie’s problem was getting worse. The internist finally agreed to come in and see Dottie. The internist arrived at the hospital, examined Dottie and found her abdomen to be the size of a basketball. She immediately called for a consult with a surgeon who recommended exploratory procedure be performed.
Dottie was wheeled to the operating room, her abdomen was opened and the surgeon found her appendix had ruptured, spilling puss and blood into her abdominal cavity. Dottie developed sepsis, blood poisoning and almost died. She spent more than three weeks in the hospital.
Suit was filed against the internist for failing to come to the hospital within the time required by the hospital’s bylaws governing physician conduct under similar circumstances. Experts were retained who testified that the doctor’s conduct in waiting more than thirty hours to examine her patient violated the appropriate standard of care required of physicians under similar circumstances. After approximately six months of trial preparation, the case was settled for a confidential sum.
MEDICAL MISTAKES – LEFT BEHIND
The following cases involve objects left behind by physicians or nurses following surgical procedures:
Marjorie, a seventy-two year old grandmother of four, underwent surgery on her pancreas. The surgery was successful but as she healed, Marjorie noticed a sharp pain whenever she moved a certain way. The pain would not go away. Marjorie’s surgeon told her he had done everything possible and “it would just take time.” A year and a half later, Marjorie was referred to another surgeon for a second opinion. Her new doctor requested a CT scan of her abdomen. The radiologist who reviewed the CT scan saw the cause of Marjorie’s problems: a surgical needle which had been left in her pancreas by the first surgeon. Marjorie underwent a second surgical procedure to remove the needle after which she healed with no problems.
Suit was filed against Marjorie’s first surgeon and the hospital staff who failed to keep count of the needles. The surgeon and the nurses denied responsibility for the needle arguing, (1) that it wasn’t a needle and (2) it must have been left during some other surgery. The case went to trial and after four days was settled by all parties for a confidential sum.
Mike underwent abdominal surgery and everything went well. His scar healed nicely except for one area which simply would not close. It continuously drained a small amount of foul smelling fluid. On eight occasions when he returned for follow-up visits, his surgeon cauterized the area to help it heal; however, it would continue to rupture and drain.
Mike sought a second opinion from another surgeon who, upon examining him, determined something had been left behind in the incision. Mike underwent a second surgical procedure to remove a piece of gauze which had been left inside him a year earlier during the first surgery. Once the gauze was removed, his wound healed and he recovered.
Suit was filed against the first surgeon who left the gauze inside Mike and the hospital where this incident occurred. After eighteen months of litigation the case appeared on a trial calendar and the parties reached a confidential settlement agreement.
Jenny underwent breast surgery to remove a suspicious mass. The doctor performed a lumpectomy instead of removing the entire breast. Following removal of the mass, the wound would not heal and for months Jenny was bothered with constant drainage and infection from the wound. One day her doctor told Jenny she was going to try a new technique and put a Penrose drain into the wound so it could heal from the inside out. The drain would be withdrawn a little bit every week as the wound healed and eventually, when the wound healed altogether, the drain would be removed.
Several days later, as Jenny was about to shower, she notice the drain had disappeared. She looked for it in her pajamas, bed, and every room in her house but could not find it. Jenny contacted her daughter, a registered nurse, who came and helped her look for the drain but likewise could not find it. The next morning, Jenny called her physician and reported the disappearance of the drain. She went into her physician’s office where a sonogram was performed to see if the drain had retracted into the wound and Jenny was told the drain must have fallen out and got lost.
Over the next ten months, Jenny’s breast would not completely heal. From time to time it would seem to burst open and a foul smelling fluid would drain. Jenny’s doctor told her she needed to consider having the breast removed since all of their healing efforts had failed. Jenny requested she be sent to a wound treatment center for evaluation and care. On her third visit to the wound treatment center, her new doctor found something inside the breast. As she pulled it out, she discovered it was two latex glove fingers. Jenny learned for the first time that her original doctor did not use a Penrose drain in Jenny’s breast; rather, she cut two fingers from a latex glove and stuffed them inside the breast instead. Her doctor failed to suture the makeshift “drain” to her breast, so the glove fingers retracted into it.
Suit has been filed against the responsible physician and this case is in litigation.
After the birth of her first child, nineteen year old Elaine felt badly most all of the time. She knew it would take a while for her body to recovery from having her baby by caesarian section and everyone told her that “feeling bad” was probably just postpartum depression. Although her condition eventually improved, she never felt quite as active and energetic as before the baby was born.
Two and a half years later, Elaine and her husband decided to have their second child. At her three month checkup, Elaine’s doctor told her there was a twelve centimeter mass on one of her ovaries. The doctor was alarmed at the size of the mass and told Elaine it was probably pre-cancerous and needed to be removed immediately. The doctor told Elaine if the mass was not removed and it proved to be cancerous, she could die. He also told her that if he attempted to remove the mass it may well cause her to lose her baby. Elaine was frantic. After discussing her situation with her husband and family, Elaine decided to postpone having the mass removed for four more months, so as to allow her baby the opportunity to develop to the point it was strong enough to survive the surgery. At seven months pregnant, Elaine underwent surgery to remove the mass which, according to the photographs of it taken by the hospital pathology department, was the size and shape of a small football. When the doctor’s sliced into the mass to examine it, they found a thirty centimeter surgical towel which had been left inside Elaine during the birth of her first child. Elaine recovered from the second surgery and successfully delivered her baby two months later.
I contacted Elaine’s first doctor and the hospital where her first baby was born. Although each denied responsibility, after six months of negotiations, the case was settled against all parties for a confidential sum.