Ureteral Trauma During Colon Surgery Lawsuit

Williams v. Surgical Associates

Operating RoomThis medical malpractice claim was filed in Prince George's County after a general surgeon damaged his patient's ureter during her colon resection surgery. It was filed in Health Claims Arbitration on March 30, 2018, and it is the 153rd medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A woman agreed to address her colon cancer with a surgery to remove part of her colon. Two weeks after the procedure, the woman went to Doctors Community Hospital with complaints of weakness, abdominal pain, and frequent vomiting. There, she learned that her ureter had been injured during the colon resection surgery. Ultimately, the damage was so severe that her right kidney had to be removed.

Plaintiff medical malpractice lawsuit alleges that the surgeon has a duty to properly identify and carefully protect the ureter and the failure to do so when performing colon resection is a breach of the standard of care.

Additional Comments
  • Ureteral trauma is a relatively uncommon complication of colon procedures, appearing after only 0.3-5% of low anterior or perineal resection surgeries. Ideally, a ureteral injury would be discovered and repaired in the intraoperative setting, but most (50-70%) are not diagnosed until the patient is recovering from surgery.
  • The left ureter does sit below the mesentery of the sigmoid colon and passes down into the pelvis which makes it accessible for injury during the surgical procedure. But with due care the ureter is generally very easy to identify.
  • A transected ureter can cause renal failure, kidney injury, hydronephrosis, pyelonephritis, deep vein thrombosis, postoperative global cardiac ischemia, sepsis, postoperative pleural effusion, multi-organ failure, postoperative urinoma, postoperative psoas abscess, and postoperative peritonitis.
  • The focus of this case will likely be less on the injury to the ureter - which the defense doctors are going to call a known risk - but the failure to identify the injury. A two week days is a substantial delay in attempting to repair the injury.
Jurisdiction
  • Prince George's County
Defendants
  • Surgical Associates Chartered
  • Jacques A. Zephirin, M.D., general surgery
Hospitals Where Patient was Treated
  • Medstar Southern Maryland Hospital Center
  • Doctors Community Hospital
Negligence
  • Failing to order preoperative imaging to map the location of the claimant's ureters before proceeding with the surgery.
  • Failing to place temporary ureteral stents before performing the surgery.
  • Failing to properly identify, visualize, and protect the claimant's right ureter during surgery.
  • Failing to recognize that the right ureter had sustained damage during the course of the surgery.
  • Failing to appropriately address the ureteral injury with a stent before completing the surgery.
Specific Counts Pled
  • As a direct result of the defendants' negligence, the claimant suffered permanent injuries including a ureteral injury and an injury to her right kidney. She had to have a nephrostomy tube placed, undergo numerous tests and procedures, and have her right kidney surgically removed.
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