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ERCP Bowel Perforation Lawsuit Against Hopkins

Pauzer v. Johns Hopkins Hospital

This is a surgical error/sepsis misdiagnosis case filed against Johns Hopkins after complications following an ERCP. This case is the 416th medical malpractice case filed in Maryland in 2016 and was filed in Health Claims Arbitration on August 22, 2016.

  • Another ERCP lawsuit, this one filed in Ellicott City in 2017. In this case, A woman undergoes an ERCP procedure to investigate abdominal pain, guided by a gastroenterologist from Gastro Associates, considering her familial history of pancreatic cancer. The ERCP, a diagnostic procedure that employs a scope to probe ailments in the liver, pancreas, and other parts of the digestive system, subsequently induces post-ERCP pancreatitis. The woman spends nearly a year hospitalized with severe abdominal pain as trapped digestive enzymes severely damage her pancreas. Now, each meal necessitates a cocktail of pills to emulate the enzymes that break down her food. The primary contention of the case revolves around informed consent – the patient was not notified of her heightened risk of developing pancreatitis due to multiple factors, including age and gender. Further, the potential benefits of the procedure were reportedly minimal for her. The jury, after rigorous examination of medical literature and case specifics, awarded her just over $1 million for past medical expenses, $1 million for lost wages, $72,000 for future medical expenses, and $3 million for noneconomic damages. However, Maryland’s cap on noneconomic damages in healthcare malpractice cases reduced the last figure to $740,000.
  • Filing a medical malpractice case after an ERCP

Summary of Plaintiff’s Allegations

A 61-year-old woman has an endoscopic retrograde cholangiopancreatography (ERCP) done by a gastroenterologist and a gastroenterology fellow at Johns Hopkins Hospital.

Postoperatively, she does not do well. She complains of abdominal pain. She is admitted to Johns Hopkins for concerns of post-ERCP pancreatitis. An abdominal x-ray reveals a possible small amount of free air, and this is discussed with her doctor the same day. The doctor does not request additional imaging studies. Pain medication is administered, but she is never examined by the doctors who performed the ERCP. Over the course of several days, the plaintiff’s pain is rated between an 8-10/10. She is discharged with a prescription for pain control.

A registered nurse called her two days after discharged to ask her about her hospital stay. At this time, the woman tells her that she is confused about her medications and unable to remember her husband’s phone number to call for help. She admits that she has been in a state of confusion since she returned home from the hospital. However, the RN on the phone does not recommend any treatment.

Another phone call is made the next day, by a different RN, to the plaintiff. This time, her husband answers, and reports that his wife is still confused and was still taking the pain medication four times a day due to abdominal pain and nausea. A follow-up appointment with her primary care physician is confirmed, for nine days later.

The next day, the woman is transported via ambulance to Schuylkill Medical Center due to a change in her mental status. At intake, she is noted to be sleepy, lethargic, nauseated, and with poor oral intake. She is transferred to Lehigh Valley Hospital the same day, where a CT scan and work up is consistent with sepsis, secondary to perforated duodenum with extensive retroperitoneal fluid collection. Extensive bowel reconstructive surgery is required.

Plaintiff alleges that this was a result of the negligence of the doctors during her initial ERCP at Johns Hopkins Hospital and that she will continue to suffer pain and permanent injuries to her gastrointestinal system. Specifically, she had to have an exploratory laparotomy to correct the bowel perforation, drainage of retroperitoneal abscess, creation of a retro-colic retro-gastric gastrojejunostomy, placement of a feeding tube, and a PICC line for nine months.  She also had to endure tube feedings until the tube was removed as she was unable to eat or drink for almost three months. She now has an enhanced risk of adhesions, abdominal pain, intestinal obstructions, and other digestive disorders as a result.

Additional Comments

  • The last ERCP verdict in Baltimore City was a Miller & Zois verdict April 2016. Our client was awarded $1.53 million for an unnecessary ERCP.
  • One of the next great mass torts may involve pancreatitis from Viberzi which is a treatment for IBS that has been linked to pancreatitis.
  • A bowel perforation is just what it sounds like. It is a hole in the intestine.
  • Bowel perforations occurring an ERCP do not, by themselves, show that the surgeon fell below the applicable standard of care. However, bowel perforations are among the deadliest potential complications of an ERCP. A doctor needs to identify and resolve the perforated bowel. Like the case we recently tried, the key to the case is whether the doctor’s care of the patient fell below the standard of care not to identify the problem either during or after surgery until it was too late for permanent injury.


  • Baltimore City


  • Johns Hopkins Hospital
  • Johns Hopkins Health System Corporation

Hospitals Where Patient was Treated

  • Surgical Positioning Johns Hopkins Hospital
  • Schuylkill Medical Center
  • Lehigh Valley Hospital


  • Failure to adequately train and permit the Fellow to provide substandard care without sufficient training, experience, and/or understanding
  • Failure to diagnose a bowel perforation before discharge
  • Failure to adequately respond to the comment of free air in the abdominal X-ray report
  • Failure to communicate between the doctor who performed the surgery and the GI team regarding continued pain; failure to seek GI and surgical consultations
  • Failure to do an adequate follow-up
  • Negligently discharging a patient without a reasonable explanation as to cause of underlying pain and abnormal x-ray findings
  • Failure during the two post-discharge phone calls to properly advise the plaintiff

Specific Counts Pled

  • Negligence
  • Loss of Consortium – Husband

Plaintiff’s Experts and Areas of Specialty

Getting a Lawyer for Your Malpractice Claim

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