Case details

Doctor: Treatment of intestinal problems was appropriate





Result type

Not present

emotional distress, mental, psychological
On June 15, 2010, plaintiff Shoshanna Miller-Scheulin, 48, presented to Dr. Rupert Horoupian at First Surgery Consultant Medical Group with complaints of abdominal pain since May 2010. She subsequently underwent a CAT scan, which Horoupian read as showing intussusceptions, a problem with the intestine in which one portion of the bowel slides into next, at her jejunum, part of the small bowel. As a result, Horoupian recommended that Miller-Scheulin undergo surgery as soon as possible. Subsequently, on July 1, 2011, Horoupian laparoscopically resectioned the portion of the jejunum that had the intussusceptions, and Miller-Scheulin was discharged on July 7, 2010. The following morning, Miller-Scheulin contacted Horoupian to inform him about the recurrence of upper abdominal pain. As a result, Horoupian readmitted Miller-Scheulin, and told her that there was now a total blockage and that she would have to have emergency surgery. Horoupian then performed a bypass of the blockage. The day after her surgery, Miller-Scheulin was transferred to UCSF Medical Center in San Francisco, where she underwent additional treatment, including another surgery on July 21, 2010. She was ultimately discharged home on Aug. 21, 2010. Miller-Scheulin sued Horoupian and his employer, First Surgery Consultant Medical Group. She alleged that Horoupian failed to properly perform the surgeries and that these failures constituted medical malpractice. She also alleged that First Surgery Consultant Medical Group was vicariously liable for Horoupian’s actions. Miller-Scheulin claimed that Horoupian negligently performed the surgery on July 1, 2011, causing her to experience significant pain shortly thereafter. She also claimed that after she awoke from the second surgery, she was in excruciating pain and asked for pain medication because the epidural had no impact on her. Miller-Scheulin alleged that as a result, her family insisted that she be transferred to UCSF, where physicians there had to perform further surgery to resection her jejunum. Thus, she claimed Horoupian negligently performed both surgeries, requiring the UCSF physicians to fix his mistakes. Defense counsel argued that Horoupian was not negligent and that his actions did not depart from the standard of care. Horoupian claimed that during the first procedure, on July 1, 2011, he performed a small bowel resection with primary anastomosis removing the area of the small bowel that was affected by the intussusception. He alleged that Miller-Scheulin tolerated the procedure, was sent to recovery without incident, and was ultimately discharged home after it was determined that she was doing well. Horoupian claimed that when a significant obstruction was discovered at the site of the recent anastomosis, Miller-Scheulin was taken back to surgery for an exploratory laparoscopy, but the procedure was converted into an open surgery when dense adhesions were discovered. He alleged that as a result, he performed a bypass of the duodenum to a portion of the jejunum beyond the area of the adhesions. In addition, defense counsel noted that Miller-Scheulin experienced another obstruction following the UCSF surgery. The defense’s laparoscopic surgery expert opined that Horoupian’s care and treatment of the patient were within the standard of care. The expert testified that the obstruction that occurred following the initial surgery may have been caused by an anastomotic leak, but that this leak is a potential complication of performing an anastomosis of the bowel and that this complication can occur without breaching the standard of care. The expert also testified that Horoupian’s performance of the second surgery was appropriate since the other option, a resection and primary anastomosis, might have been dangerous to the patient due to the proximity of the adhesions to the mesenteric artery and veins., The day after Miller-Scheulin’s second surgery, she was transferred to UCSF Medical Center in San Francisco, where she underwent additional treatment, including another surgery on July 21, 2010. She claimed that she spent weeks following her last surgery with diarrhea, vomiting, CAT scans, endoscopies, X-rays, blood tests, physical exams, bandage changes, and pain and anti-nausea medication. Miller-Scheulin was also placed on a feeding tube and a nasogastric tube, as well as was seen by a neuropsychologist to help her cope with the psychological and emotional effects. She was ultimately discharged home on Aug. 21, 2010. Miller-Scheulin claimed that she can no longer tolerate most meat, most vegetables, any beans or nuts, and often has urgent diarrhea. Her psychiatrist prescribed anti-depressants and medication for treating post-traumatic stress disorder. In addition, Miller-Scheulin lost 27 pounds during her hospitalization. Thus, Miller-Scheulin sought recovery of general and compensatory damages, as well as damages for her loss of income, and loss of power to earn, and accumulate money and property. In addition, she sought recovery of costs and attorney fees. According to defense counsel, plaintiff’s counsel asked the jury to award Miller-Scheulin $1.3 million, plus general damages.
Superior Court of Alameda County, Oakland, CA

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