Gynecological Surgery Bowel Perforation Lawsuit

Herzog v. Johns Hopkins Hospital

This medical malpractice claim was filed in Baltimore City after a negligent laparoscopic surgery caused a bowel perforation and sepsis. It was filed in Health Claims Arbitration on March 23, 2018, and it is the 140th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A woman presented to Johns Hopkins with abnormally heavy menstrual bleeding, menstrual cramps, pelvic pain, an ovarian cyst, and endometriosis. Her gynecologist recommended several surgical procedures including a total laparoscopic ovarian cystectomy, a hysteroscopy, and a chromopertubation. The plan was for the gynecologist to remove the woman's cyst and to better visualize the uterus and fallopian tubes in order to diagnose the cause of her abnormal bleeding.

During surgery, there was a small amount of bleeding when gynecologist initially inserted the laparoscopic equipment into the woman's abdominal cavity. The gynecologist reported that the bleeding was not active and soon stopped. He encountered more bleeding throughout the procedure, which he controlled with a cautery. At no point was the woman's bowel inspected.

In the days following her surgery, the woman displayed a variety of concerning abdominal symptoms, including pelvic pain, fatigue, nausea and vomiting, poor appetite, and confusion. The woman's mother took her to the Emergency Department at the University of Maryland Upper Chesapeake Medical Center, where a CT scan revealed pneumonia and a bowel injury.

More specifically, there were abnormal collections of air and fluid in the woman's peritoneal cavity, near the liver and pelvis, causing abdominal swelling. Throughout the day, the woman's heart rate quickened, she became short of breath, and her abdominal pain continued. She was transferred back to Johns Hopkins with sepsis and a suspected bowel injury. At Hopkins, the woman underwent additional surgical procedures to repair her bowel injury and treat her infection.

Additional Comments
  • Plaintiff's argument will likely be that if you are cutting, you have to know where you are. If you do not know, convert the procedure to an open so you can get a better view.
  • Plaintiff's second argument is if that even if cutting the bowel was not negligent, not identifying and solving the problem is negligence.
  • Sepsis is a serious complication of infection that can progress to septic shock and death. Patients who survive sepsis can expect a difficult recovery with lingering physical symptoms including weakness, breathlessness, loss of appetite, dry skin, and difficulty sleeping. Eventually, most sepsis survivors make a complete recovery. In rare cases, some patients suffer long-term effects such as insomnia, cognitive impairment, organ dysfunction, and pain.
Jurisdiction
  • Baltimore City
Defendants
  • The Johns Hopkins Health System Corporation
  • The Johns Hopkins Hospital, Inc. d/b/a The Johns Hopkins Hospital
  • The Johns Hopkins Hospital
  • Johns Hopkins Community Physicians, Inc.
  • Johns Hopkins Health Care and Surgery Development, LLC
  • A gynecologist
Hospitals Where Patient was Treated
  • Johns Hopkins Hospital
  • University of Maryland Upper Chesapeake Medical Center
Negligence
  • Failing to properly identify the claimant's anatomy during surgery to avoid perforating her bowel.
  • Failing to identify and/or discover that the claimant's bowel had been perforated during surgery.
  • Failing to appreciate the severity of the claimant's abdominal pain and other symptoms and recognize that they were being caused by a bowel perforation.
  • Failing to instruct the claimant to return to the hospital for postoperative evaluations and examinations.
  • Failing to recognize the claimant's increased risk of bowel perforation.
  • Failing to adequately place surgical equipment.
  • Failing to timely diagnose and treat the claimant, perform diagnostic testing, or call for an appropriate consult.
Specific Counts Pled
  • As a direct result of the defendants' negligence, the claimant suffered severe and painful injuries, underwent painful procedures, and incurred the expense of additional medical treatment.
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