Bowel Perforated During Gastric Bypass Surgery: $1 Million Settlement
2020 Medical Malpractice Case Settlement
By Attorney Krysia J. Syska
Middlesex Superior Court
Perforation of bowel during gastric bypass revision causes sepsis, multiple surgeries and amputation of hand
On 2/26/14, plaintiff underwent revision of his Roux-en-Y gastric bypass. He tolerated the procedure well and was discharged on 3/1/14.
On 3/3/14, plaintiff returned to the hospital with complaints of abdominal pain. CT scan was concerning for a ventral hernia. The defendants who performed the revision surgery made a plan to return to the operating room later that day for hernia repair as his pain was not improved with medication.
At the start of the procedure, the Visiport was advanced into the peritoneal cavity and during advancement of the tool it “popped” into the abdomen. The defendant noted that this had never happened before and he inspected the area for evidence of injury to surrounding structures, specifically bowel. He saw no evidence of injury so he continued with repair of a small hernia and piece of small bowel which was caught in the site. The abdomen was irrigated with saline and inspected again without incident.
Postoperatively plaintiff had an unusual amount of abdominal pain and was tachycardic. He was transferred to the ICU where his status continued to slowly worsen. Succus was noted to be coming out of one of the trocar sites. Small bowel injury was suspected so he was brought back to the OR again. During this procedure the defendant ran the small bowel and found a small puncture to the Roux limb which was approximately 4-5 mm across. The bowel was decompressed and carefully inspected for other areas of perforation. None were seen so they repaired the area of injury and sent the patient to the ICU in critical condition.
Post-operatively he was requiring maximum pressors and there was concern for abdominal compartment syndrome. That afternoon his left hand was found to ice cold and vascular surgery felt this was due to his profound pressor dependence. Later that evening decompression of the abdomen was required and inspection of the bowel revealed yet another enterotomy on the contralateral side of the same bowel where the previous repair had been done.
It was felt there had been a through and through injury to the bowel when the trocar popped into the abdomen but only one enterotomy had been seen during the exploratory surgery. It was noted at this time that plaintiff now had a necrotizing soft tissue infection of the skin and muscle.
He ultimately required multiple surgeries for his abdomen as well as amputation of the left hand.
The defense argued that the bowel was inspected multiple times and the second perforation was not detectable. However, the parties were able to resolve the claim prior to a scheduled trial with a settlement for $1,000,000.
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