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U.S. District Court, Eastern District of Pennsylvania

The estate of the 74-year-old female plaintiff contended that the defendant general surgeon negligently failed to detect a bowel laceration during surgery to repair an incisional hernia. The plaintiff also alleged that employees of the defendant hospital deviated from the required standard of care in failing to appreciate the decedent’s post-operative signs and symptoms of bowel leakage, leading to her ultimate death from sepsis. The defendant doctor argued that he did not detect bowel leakage at the time of surgery and that the cause of the plaintiff’s subsequent symptoms was unclear. The defendants maintained that the bowel leakage was diagnosed as soon as possible. Several other physicians involved in the plaintiff’s care were voluntarily dismissed from the case prior to trial.

The decedent was admitted to the defendant hospital for elective surgery to repair an incisional hernia. The laparoscopic repair surgery was performed by the defendant general surgeon on April 29, ________. The plaintiff’s surgical expert testified that the defendant was negligent in failing to perform a post-operative re-examination of the plaintiff’s bowel at the end of the surgery to ensure that there were no leaks. Such an examination would have revealed that a bowel laceration had occurred during the surgery, according to the plaintiff.

The defendant surgeon was not working at the hospital over the weekend following the decedent’s surgery. The plaintiff claimed that the decedent exhibited several signs and symptoms of bowel leakage, which were not appreciated by the hospital physicians in charge of her care and that these physicians administered pain management only. In addition, the plaintiff’s expert opined that the plaintiff’s diagnostic tests, including a so-called "shift to the left", indicated a high white blood count and developing infection which was not appreciated by the hospital physicians.

Four days post-operative, on May 4, ________, the decedent was being moved for a repeat CAT scan, when the plaintiff contended that fecal contents spilled out of her surgical wound. The plaintiff was diagnosed with two perforations or enterotomies in the bowel which the plaintiff claimed was caused by a bowel laceration during the surgery. The decedent underwent additional surgery to repair the bowel and the wound remained unclosed. Peritonitis and overwhelming sepsis resulted in her death eight months post- operatively.

The defendant surgeon testified that he checked for bowel leakage during the procedure and he did not believe that it was necessary to check again at the end of the procedure because if a leak were present, he would have seen it. The defense contended that the decedent’s medical presentation was complicated and that the physicians who were treating her acted reasonably in considering differential diagnosis, including a hematoma. The defense argued that there was not sufficient evidence to diagnose a bowel injury during the time in question.

After a five day trial, the jury found for the plaintiff in the amount of $________. The award included $________ for the wrongful death claim and $________ for the survival claim. The addition of delay damages increased the plaintiff’s judgment to $________. Post-trial motions are pending.

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