Case details

Patient: Surgeon failed to close gallbladder surgical wound





Result type

Not present

chronic anemia, chronic fatigue, chronic obstructive pulmonary disease, COPD, gastroesophageal reflux disease, GERD, hyperlipidemia, insulin-dependent diabetes, irritable bowel syndrome, kidney disease, morbid obesity, obstructive sleep apnea
On July 15, 2013, plaintiff Earnestine May-McNary, a retired 59 year old, underwent surgery for removal of her gallbladder by Dr. Robert Murray at St. Mary’s Medical Center, in San Francisco. May-McNary had a complex medical history, including morbid obesity, insulin-dependent diabetes, chronic obstructive pulmonary disease (COPD), chronic anemia, obstructive sleep apnea, hyperlipidemia, gastroesophageal reflux disease (GERD), kidney disease, irritable bowel syndrome, and chronic fatigue. When she began to experience epigastric pain, she underwent an ultrasound, which revealed gallstones. As a result, it was determined that May-McNary needed to have her gallbladder removed. Murray subsequently commenced a laparoscopic cholestectomy, which he converted to an open procedure through a right, upper quadrant incision. May-McNary then remained hospitalized at St. Mary’s for four days without any apparent complications. Four days after being discharged from St. Mary’s, May-McNary was seen in the emergency room at California Pacific Medical Center, in San Francisco, with abdominal pain, a white blood cell count of 24,000, and a CT scan showing a dehiscence. The wound allegedly had the appearance of being about to burst open. May-McNary was subsequently taken emergently to the operating room for an exploratory laparotomy, lysis of adhesions, and abdominal wound closure by Dr. Laurence Yee, a colorectal surgeon, and Dr. Edward Miranda, a reconstructive surgeon. During the surgery, it was discovered that there were several sutures from the liver to the anterior fascia (the connective tissue used to close abdominal wounds). Thus, Miranda and Yee concluded that Murray had mistaken May-McNary’s liver for the inferior (or lower) edge of the fascia. May-McNary sued Murray, alleging that Murray had negligently performed the gallbladder removal surgery and that this negligence constituted medical malpractice. Plaintiff’s counsel argued that Murray was negligent in closing the open gall bladder surgical wound. Specifically, counsel contended that Murray stitched May-McNary’s liver to her abdominal wall, in effect, leaving the fascia open and allowing the colon to herniate through the opening. Murray claimed that he appropriately closed the surgical wound and that May-McNary’s surgical wound dehisced occurred post-operatively due to her multiple comorbidities that put her at risk for poor wound healing. Murray further claimed that he did not sew the superior fascia to the liver, but, rather, the sutures became adhered to the surface of the liver, as the two structures are in contact in the abdomen., May-McNary suffered a wound dehiscence, causing her colon to herniate through the opening. As a result, she required an emergency exploratory laparotomy, lysis of adhesions, and abdominal wound closure. She also required two additional surgical procedures and multiple hospitalizations, including 40 in-patient days. On Sept. 3, 2013, the plaintiff’s treating reconstructive surgeon, Miranda, performed a surgery that involved draining the intra-abdominal abscess, removal of the infected mesh that had been placed, and debridement of the abdominal wall due to an infection with necrosis. On Oct. 16, 2013, another surgery was performed, consisting of split thickness skin grafting to cover the defect of the abdominal wall. Presently, May-McNary has multiple abdominal hernias and wears an abdominal binder. In addition, she claimed that she continues to have pain and distension of her abdomen, limited ability to bend/lift, and an obvious abdominal disfigurement. She also claimed that a disfiguring scar on her abdomen made her self-conscious. She further claimed that she suffered emotional distress and pain and suffering related to her multiple surgeries and extended hospitalizations for her surgeries and rehabilitation periods. May-McNary did not make a claim for lost wages and she did not seek economic damages, as her medical expenses were paid by her health insurance carrier. Thus, she only sought recovery of damages for her past and future pain and suffering. Her husband, plaintiff Price McNary, a retired 69 year old, made a claim for his loss of consortium. He claimed that due to his wife’s wounds, he has to assist her with bathing and getting dressed.
Superior Court of San Francisco County, San Francisco, CA

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