Gastric Bypass Death Settlement: $2.75M
2015 Medical Malpractice Trial Report
Lawsuit claims patient death due to trocar laceration of inferior vena cava due to negligence of surgeon
The plaintiff’s decedent was an unmarried 29 year old woman with no children who died as a result of a trocar laceration of her inferior vena cava during gastric bypass.
On 12/21/10, the patient underwent elective laparoscopic bariatric gastric bypass surgery. The defendant surgeon made an incision to the left of the umbilicus and inserted an 11 mm non-cutting direct view laparoscopic trocar device. When he removed the trocar, he immediately saw blood in the trocar that extended down the insufflation tubing. A second trocar was placed in the right upper quadrant to visualize the bleeding point. However, with insufflation of CO2, it was believed by the anesthesiologist that an air embolus had occurred. At that point, insufflation was stopped and the trocars were removed.
The defendant then called for a stat intraoperative consultation with another surgeon who presumed that a retroperitoneal vessel injury occurred. After the insufflation was turned off, a midline incision was made. The retroperitoneal space was examined and a small 1 cm puncture wound was noted approximately 10 to 15 cm superior to the pelvic brim. No active bleeding was seen. Sutures were placed deep into the wound and the abdomen was closed. Total blood loss was 350 ml.
The patient was transferred from the operating room to the intensive care unit (ICU). Almost immediately upon arrival to the ICU, she became tachycardic, hypotensive, complained of nausea and was dry heaving. It was felt she was suffering from a re-bleed of her vena cava injury which was causing a massive retroperitoneal hematoma. Vigorous fluid resuscitation continued over the next hour.
The patient became unresponsive and was intubated. Her pulses were difficult to palpate. She showed signs of coagulopathy and was started on fresh frozen plasma. She became restless, and her blood pressure was difficult to obtain.
She was transferred by med flight to a trauma hospital and taken emergently to the operating room due to her critical condition. Upon opening the abdomen extensive swelling of the bowel and a presumed abdominal compartment syndrome were noted. There was a large evacuation of blood and a tremendously large retroperitoneal hematoma with massive amounts of exsanguination. She became asystolic (no pulse) and CPR was performed with no return of a heart rate or blood pressure and she was pronounced dead.
The plaintiff claimed the patient’s death was due to a trocar laceration of the inferior vena cava, caused by the negligence of the defendant surgeon. The defendant contended he complied with the standard of care and the death was an unfortunate and unpredictable consequence of this high risk operation.
The case settled at mediation for $2,750,000.
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