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Delay in Diagnosis of Gastric Bypass Complication

$8,999,998 – Medical Malpractice/Negligence; Fraud

Facts

Inexperienced doctors and hospital fail to diagnose complications in a bariatric gastric bypass/lap band patient who lost most of her intestines due to ischemia.

40-year-old Ms. C, a longshoreman, presented twice to Defendant Hospital for abdominal pain, nausea and vomiting. She had a history of both gastric bypass surgery and lap banding. The Defendant Hospital did not have a bariatric surgery program, nor did it even have surgeons on staff with experience in bariatrics. The emergency room physician had never dealt with a patient with a similar medical history. He failed to obtain a CT scan to investigate the plaintiff’s complaints. He also failed to obtain a surgical consult despite the gastroenterologist’s recommendation to him that one be obtained. Ms. C was admitted to the hospital based on the emergency room physician’s recommendation. She was never told the hospital did not provide bariatric surgeons or bariatric services. Over the next four days her condition deteriorated. She developed sepsis, renal failure and respiratory failure. Finally, a general surgeon was consulted, who determined that a bariatric surgeon was needed. This resulted in her transfer to a bariatric surgeon at a facility with bariatric services. Emergency surgery revealed a torsion (twist) in her bowels at the site of the sutures from the gastric bypass surgery. Unfortunately, by this time, most of Ms. C’s bowels had died from ischemia and had to be removed. Ms. C now requires a total parenteral nutrition (TPN) and gastrostomy tube feedings for the rest of her life or until she receives an experimental small bowel transplant.

Allegations/Contentions

Plaintiff alleged that her presentation on June 15th required immediate consultation with a bariatric surgeon. As a result of the failure of the physicians to recognize the complication and their failure to consult an appropriately trained bariatric surgeon, the delay in treatment caused irreversible ischemic damage to most of plaintiff’s bowels. Furthermore, plaintiff alleged that the Hospital failed to have a system in place to identify patients who require bariatric services that it could not provide. The Hospital failed to recognize her need for bariatric services. Plaintiff also alleged that the hospital staff failed to properly monitor her and failed to go up the chain of command when her condition deteriorated and the physicians were not appropriately intervening.

All settling defendant contended they met all applicable standards of practice and care and that a bariatric surgeon or transfer to another facility was not required. Defendants contended that there was nothing in her condition that signaled the need for a surgical consult until June 18th, and that by then it was too late to make a difference. Defendant ER doctor contended that all of the other defendants that settled were negligent, but he was not. Several of his own experts testified that Ms. Doe required a surgical consult on the 15th, and that had she received the surgical consult, she would have been taken to surgery and would not have suffered any of the injuries and damages she now has. However, they testified that the responsibility for getting this surgical consult fell to other doctors, not Defendant ER Doctor.

Injuries/Damages

Injuries/Damages: As a result of the delay in treatment, plaintiff now suffers from short bowel syndrome requiring parenteral nutrition and gastrostomy tube feedings for the rest of her life. She was also unable to return to her job as a longshoreman.

Special Notes

Shortly after the Defendants GI Doctor, Hospitalist Doctor, and General Surgeon were deposed, plaintiff served each with a demand for settlement pursuant to Code of Civil Procedure Section 998 for their $1 million insurance policies. All three consented to settle for just shy of their respective policy limits. Plaintiff rejected Defendant ER Doctor’s $25,000, and $50,000 offers. On December 18th, Plaintiff and Defendant Hospital and Defendant ER Doctor went to mediation. Following mediation, Defendant Hospital settled for a total payment of $6,000,000. The ER Doctor’s highest offer was $250,000, which was rejected by plaintiff. Total settlement as to all parties except the ER Doctor was $8,999,998.


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