safety is our priority

Medical Malpractice Jury Verdict – Failure to Treat Postop Infection

Thomas W. Hall

On June 23, a 42-year-old female patient represented by Atlee Hall received a $350,000 verdict for noneconomic damages after the Philadelphia jury found the defendant surgeon and his practice responsible for failing to timely diagnose and treat an infection that developed following surgery to remove uterine fibroid (noncancerous) tumors. Ultimately, the untreated infection resulted in the need for a hysterectomy and creation of a temporary colostomy.

Postoperative infections in a hospital setting have been declared “Never Events” by the U. S. Department of Health and Human Services, meaning that such events are “unambiguous (clearly identifiable and measurable), serious (resulting in death or significant disability), and usually preventable.” Nevertheless, the CDC estimates that there are 1.7 million hospital acquired infections each year that result in nearly 100,000 deaths, and cost our US healthcare system between $28 billion-$33 billion each year. But even these figures do not account for the cost in human carnage created by these infections that should be prevented in the first place, or at least recognized in a timely manner and appropriately treated if they do occur.

In this case, in spite of spiking temperatures, a positive blood culture and a climbing white blood count (cardinal signs of an infection) the treating doctor failed to order a CT scan to determine if the patient had an abdominal abscess. In fact, the doctor stopped the patient’s antibiotic therapy believing that the patient’s symptoms were a benign reaction from the trauma of surgery. This situation, where a doctor must evaluate a patient who has symptoms that could be from any number of medical conditions, is among the most common situations encountered by virtually every physician. The surgeon violated one of the most basic Patient Safety Rules which if followed, could have prevented this unnecessary complication.

Safety Rule No. 1

A doctor must make a list of all possible diagnoses, and if any possible diagnosis on the list is an eminently life or limb threatening condition, the doctor must assume the patient has that condition until tests are done to prove that it is not, in order to protect patients from unnecessary harm.

Unfortunately, some physicians, after making a list of all possible diagnoses, simply assume the correct diagnosis is the condition they think is most likely, completely ignoring that the patient might have a less likely but more eminently deadly condition. By way of example, the vast majority of the approximately 6 million people who visit the emergency rooms across the United States because of a chief complaint of chest pain do not have life-threatening condition. Non-emergent diseases of the lungs, esophagus, stomach, mediastinum, Laura and abdominal muscles mail cause chest pain. But a small percentage of chest pain patients are in fact having a having a life-threatening event, such as a heart attack. For this reason, the reasonable and prudent emergency room physician assumes that the patient is having a heart attack, until appropriate tests are done to prove the patient is not having a heart attack.

In this case, the jury’s message was clear that violating this basic patient safety rule will not be tolerated, and those who violate the rule will be held accountable. Hopefully, the jury’s message will save future patients from suffering a similar fate.

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