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Bowel Perforation Malpractice

Surgery

A perforated bowel is a hole in the intestines. The bowel, made up of the small and large intestines, is the long, tubular part of the digestive system below the stomach where nutrients and water are absorbed into the bloodstream. Bowel perforation may also be called an intestinal or gastrointestinal perforation, in reference to the gastrointestinal, or digestive system. Bowel perforation is a medical emergency, and if it is not repaired, serious health problems can result.

Sometimes, during surgery in the abdominal area, a surgeon will accidentally cut or nick the bowel. If you suffered a perforated bowel and believe your injuries were caused by a medical mistake, call 800-553-8082, or get a free online consultation.

How Does a Perforated Bowel Happen?

Some examples of conditions that might cause a bowel perforation are diverticulitis, ulcerative colitis, Chron's disease, and appendicitis. If you have diverticulitis, for example, small "pouches" form on the intestine and push outward. Trauma to the intestine, from a severe blow, gun or knife wound, or swallowed object, can also tear the intestines.

More commonly, trauma to the intestine is accidentally inflicted during abdominal surgeries such as hysterectomies, appendectomies, and laparoscopies. A surgeon may nick or cut the bowel while performing surgery in the abdominal area. Additionally, a hole can be made when staples or stitches used to close the bowel come undone after surgery. Rarely, perforations occur during endoscopies and colonoscopies.

What are the Effects of a Perforated Bowel?

Stomach pain, vomiting, chills, nausea, fever, abdominal pain, and trouble moving are signs of a perforated bowel. Having a hole in any organ is dangerous. A hole in the intestines allows its contents, including stool and bacteria, to enter the abdominal cavity. The human digestive system is host to diverse microbiome-bacteria in the gut aid in digestion and overall health. However, when stool and bacteria leak into the abdomen, an infection called peritonitis may develop which can lead to sepsis.

Sepsis is a medical emergency that causes organ failure and even death if left untreated. When the immune system responds to a bad infection, the response can be too intense for the body to handle. Immune chemicals cause inflammation, blocking the flow of blood to one or more organs. Symptoms of sepsis include fever, chills, rapid breathing and heart rate, signs of infection, pain, and mental decline.

How is a Perforated Bowel Diagnosed and Treated?

If any of the symptoms of perforated bowel are present, especially after abdominal surgery, a doctor should be seen immediately. X-rays showing air in the chest alert the doctor to the possibility of a perforation, and CT scans confirm the perforation and pinpoint its location. Blood testing reveals signs of infection and blood loss.

Rarely, a perforation can heal on its own, but most of the time emergency surgery is required. The surgeon will fix the hole or holes in the bowel and remove anything that leaked from the bowel into the abdominal cavity. Antibiotics will probably be administered to treat possible infection.

In some cases, the surgeon will perform a colostomy or ileostomy, diverting the contents of the intestine into a bag through a hole in the abdomen. Those procedures are intended to promote healing and are reversed in a second surgery whenever possible.

The amount of time that the perforation was left open and a patient's overall health can influence the success of surgery. However, timely surgery usually fixes the problem without significant effects on a patient's health.

If I Suffer a Bowel Perforation During a Medical Procedure, is that Malpractice?

The defense in a bowel perforation medical malpractice or wrongful death case will argue that bowel perforation is an accepted risk in most abdominal surgeries. And, they are often right. A bowel perforation can happen even when a surgeon is being careful and using the correct techniques. In medical malpractice cases, plaintiffs must show that a defendant violated the standard of care.

The perforation of the bowel itself is not malpractice unless a plaintiff can show, by consulting with experienced professionals, that the injury was inflicted as a direct cause of the surgeon's negligence. They may argue, for example, that the surgeon used outdated techniques or accessed an area of the bowel that was not involved in the original plan.

Usually, perforated bowel cases do not take issue with the perforation itself, but rather with the way healthcare professionals respond to the perforation. Depending on the circumstances, a bowel perforation should either be recognized during surgery and corrected, or symptoms of a perforated bowel should be noticed and taken seriously after the surgery. Timely diagnosis can prevent extended hospital stays, the need for a coloscopy or ileostomy bag, and death.

Some patients may show fewer outward symptoms than others. However, a bowel perforation can be detected from other observations, by tracking bowel movements and gas patterns, or by noticing abdominal distension, for example.

Again, the defense will likely argue that the signs and symptoms of bowel injury are not always apparent and can resemble other conditions, often leading to a failure to diagnose. However, qualified experts understand what the standard of care is in a given situation and can identify when medical negligence is responsible for an untreated bowel perforation.

Example Verdicts and Settlements
  • 2019, Pennsylvania: $1,000,000 Settlement: A 65-year-old woman undergoes surgery to reverse her colostomy and insert a pain management device. During the course of the surgery, the three defendant doctors cause a small bowel defect. In the days following the operation, the woman exhibits signs of bowel perforation which the defendants do not address apart from administering saline and continuing to monitor her. The woman is vomiting and has low blood pressure, abdominal distention, and a rapid heart rate. Three days after the surgery, she dies. In this case, the woman's estate argued that the defendants were negligent in making the perforation, failing to notice it before completing the surgery, failing to respond to tests and symptoms of bowel perforation, delaying its diagnosis, as well as failing to repair the bowel in a timely manner.

  • 2019, New York: $500,000 Settlement: A 10-year-old boy, represented by his mother, has a bowel perforation after getting a urachal cyst surgically removed. They contend that the boy's doctor was negligent in the techniques he used during the surgery. A secondary complaint was that the doctor did not receive the boy's informed consent.

  • 2019, Idaho: $893,422 Verdict: A 49-year-old woman undergoes a complete hysterectomy. While operating, the defendant surgeon notices a tear on her bowel and later says that he repaired it at that time. The woman is discharged the next day but returns to the hospital for emergency surgery within three days because she has become septic. Surgeons discover a bowel perforation which has been leaking, causing septic shock. The defendant surgeon never informed his patient about the perforation that he found and supposedly repaired during the initial surgery. During the trial, the woman passes away. General damages account for most of the verdict, with the remaining accounting for medical costs.

  • 2019, New York: $13,000,000 Verdict: An adult woman dies due to post-operative septic shock. She goes into sepsis after her bowel is perforated during a diagnostic laparoscopy and partial colon resection. According to her estate, doctors failed to provide her with informed consent about the surgery and delayed the diagnoses of her condition. A mother survived by her husband and two children, $2,250,000 is awarded for compensatory pain and suffering and $10,750,000 for loss of services.

  • 2018 New York: $1,000,000 Settlement: A 28-year-old woman with a history of cervical cancer develops radiation colitis, inflammation caused by radiation therapy, and is treated with antibiotics. About a month later, she returns to the hospital, where a small bowel obstruction is found. She requires an exploratory laparotomy surgery, during which surgeons suture her colon. After the surgery, the woman feels a pop, followed by pain in her abdomen. She has experienced a perforation where the suture was made, which results in septic shock, a one month stay in the hospital, and use of an ileostomy bag for the next five years. The plaintiff argues that the doctors that performed the exploratory laparotomy should have done a bowel diversion, either a colostomy or ileostomy, at that time to prevent the perforation and its consequences.

  • 2018, Pennsylvania: $345,000 Settlement: An 81-year-old women is diagnosed with a ventral hernia. In the first procedure to repair the hernia, the woman shows signs of infection. As a result, she goes back into surgery two days later, and passes away from the complications of that surgery. According to the defense, the patient's death was a result of her long medical history and not their negligence. However, the plaintiff, aided by an expert in minimally invasive surgery, claims that the defendants were negligent for a number of reasons, including the perforation of her bowel. The defendant doctor performed lysis of adhesions, surgical cutting of bands of tissue that form between organs, unnecessarily, increasing the risk of bowel perforation. The doctor did not have the consent of the decedent to perform lysis of adhesions beyond the repair of her hernia.

  • 2018, New Jersey: $1,850,000 Settlement: In this case, a 59-year-old woman is left with short gut syndrome, affecting her quality of life, after her bowel is perforated during oophorectomy, or ovary removal, surgery. When accused of not checking the bowel for perforations before completing the surgery, the defendant surgeon proves using the operative report that he was checking during the surgery. However, there is no record of him performing a final check for bowel perforations before finishing the surgery. The woman has a high risk of bowel perforation due to a history of bowel resection and diverticulitis. After the surgery, cannot be discharged right away because she has a very high heart rate, hypoxia, and abdominal pain. Despite her predisposition for bowel perforation and her post-operative symptoms, a CT scan is not performed to check for perforations.

Contact Miller & Zois About Perforated Bowel Malpractice

If you or a family member have been injured by a perforated bowel due to negligent medical care, you may be entitled to financial compensation. Call our medical malpractice attorneys today at 800-553-5053 or contact us online.

Sources
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