Case details
Patient wanted ileostomy taken down, defense argued
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
colon, digestive, gastrointestinal, ileostomy
FACTS
On Sept. 5, 2012, plaintiff Laura Roberts, 72, a part-time mobile home park manager, underwent surgery to address her leaking colonic anastomosis. The surgery was performed by Dr. Arthur Schwartz, a general surgeon. Roberts previously had repeated hospitalizations due to abdominal pain and constipation. As a result, she began seeing Schwartz in 2011. Testing revealed some form of inflammatory bowel disease in Roberts’ sigmoid colon. On April 30, 2012, which was Roberts’ second hospitalization for the same complaints in 2012, Schwartz performed a sigmoid colon resection, anastomosis, and a loop ileostomy. Post-operative pathology revealed Crohn’s disease in the resected sigmoid colon. Shortly after Roberts’ discharge from the hospital, her colonic anastomosis began leaking and eventually formed a fistula to the skin through one of her operative incisions. Schwartz subsequently managed Roberts’ condition conservatively through the summer of 2012, hoping that he could get the fistula and leak to seal off without further operative intervention. However, this was not successful. As a result, on Sept. 5, 2012, Schwartz took Roberts back to surgery to resect her leaking colonic anastomosis, create a new colonic anastomosis, and take down her loop ileostomy. Unfortunately, both of the anastomoses created by Schwartz broke down two weeks after the surgery. Roberts was subsequently transferred to Renown Medical Center, in Reno, Nev., on Sept. 21, 2012. She came under the care of a colon and rectal surgeon, who began a number of surgeries to attempt to restore the continuity of Roberts’ gastrointestinal tract. Unfortunately, every time that the treater attempted to restore the continuity of Roberts’ GI tract, the newly-created anastomosis would leak. The treating colorectal surgeon ultimately performed his fourth and final surgery on Roberts on March 28, 2014, during which he removed all but a small terminal segment of Roberts’ colon and created a permanent ileostomy. Roberts has had no complaints regarding her GI tract since the last surgery. Roberts sued Schwartz, alleging claims of medical malpractice. The plaintiff’s expert colorectal surgeon testified that Schwartz fell below the standard of care by choosing to take down the protecting ileostomy during the Sept. 5, 2012 surgery. He opined that, because Roberts had a known diagnosis of Crohn’s disease at that point, Schwartz should have been aware of the high likelihood of failure of a new colonic anastomosis in the absence of a protecting ileostomy. The expert also felt that Schwartz fell below the standard of care by not consulting with a gastroenterologist between the two surgeries to medically manage Roberts’ Crohn’s disease with immunosuppressive medications. The defense’s gastroenterology expert testified that a GI consult was not required between Schwartz’s two surgeries because immunosuppressive medications could not have been administered to Roberts given her active infection, anastomotic leak, and fistula. The defense’s general surgery expert testified that it would have been within the standard of care to either take down the ileostomy during the second surgery or leave it in place. He noted that Roberts wanted the ileostomy taken down at the time of the second surgery, and he also noted that there was a much better bowel preparation for that procedure, making the ileostomy less necessary., After both of the anastomoses created by Schwartz broke down, Roberts was transferred to Renown Medical Center, in Reno, Nev., on Sept. 21, 2012. She came under the care of a colorectal surgeon, who began a number of surgeries to attempt to restore the continuity of Roberts’ gastrointestinal tract. Unfortunately, every time that the treater attempted to restore the continuity of Roberts’ GI tract, the newly-created anastomosis would leak. The treating colorectal surgeon ultimately performed his fourth and final surgery on Roberts on March 28, 2014, during which he removed all but a small terminal segment of Roberts’ colon and created a permanent ileostomy. Roberts has had no complaints regarding her GI tract since the last surgery. Thus, Roberts sought recovery of past medical costs for the total cost of the multiple surgeries that she underwent from 2012 through 2014. She also sought recovery of past and future general damages for the discomfort and embarrassment of dealing with a permanent ileostomy. At trial, Roberts sought recovery of $914,000 in total damages, including $251,000 in past medical costs, $201,000 in past general damages, and $462,000 in future general damages.
COURT
Superior Court of Lassen County, Susanville, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
- mental
- nose
- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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