Foreign Objects Left in Body

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Case: Forgotten Surgical Sponges

FACTS: Plaintiff underwent hernia mesh repair with Defendant Surgeon #1 at Defendant Hospital. After the surgery, Plaintiff developed a hematoma. Two days after the initial surgery, on a weekend, Surgeon #2 took Plaintiff back to the OR to evacuate the hematoma. At the end of that surgery, Surgeon #2 left two surgical sponges in Plaintiff’s abdomen and left her abdomen open, planning a surgery to remove the sponges and los approximately 48 hours later. Surgeon #1 took Plaintiff back to the OR 48 hours later and closed the Plaintiff’s Abdomen without removing the 2 surgical sponges Surgeon #2 left in the Plaintiff’s abdomen.

Defendants failed to realize that sponges had been left in Plaintiff until 18 days later when her ongoing complaints of abdominal pain led to an imaging study that revealed the forgotten surgical sponges in the abdomen. The sponges caused extensive infection and eventually causes Plaintiff to develop virulent clostridium difficile and sepsis.

DEFENSE: The defendants pointed fingers at one another.

INJURIES: The Plaintiff spent 97 days in the hospital, including 18 days in critical condition. She suffered fulminant clostridium difficile colitis, sepsis and disseminated intravascular coagulopathy. She underwent 11 surgeries and required 9 blood transfusion. As well as required a total colectomy and the removal of a foot of her ileum. She was administered last rites before she was flown by air ambulance to another hospital. Her vocal cords were damaged by her prolonged intubation so she required speech therapy to be able to speak normally again.

Because she lost her entire colon and a foot of bowel, Plaintiff now has 12-15 liquid, often explosive stools per day. She is unable to eat without having immediate and unimpeded access to a bathroom for approximately the next four hours. Plaintiff’s doctor advised Plaintiff that her current bowl function is what she can expect for the rest of her life. Plaintiff will continue to suffer chronic malnourishment because the removal of her colon has left her unable to absorb nutrients normally.

SPECIAL DAMAGES: Medical bills: $719, 053.00 Future medical expenses: $109,331.00

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Kimberly Kirkland (Reis & Kirkland PLLC)

NAME/ COUNTY: Anonymous vs. Anonymous

CASE: Sponge Left in Body

FACTS: At the end of an elective cholecystectomy the OR nursing staff responsible for the sponge and instrument counts reported to the surgeons that a 4″ x 4″ radio-opaque sponge was missing. The surgeons conducted a search of the wound and obtained imaging of a portion of the abdomen in the OR but failed to locate the sponge. They close the patient and sent her to the PACU. There surgeons testified that at the time they believed it was more likely that the nurses had miscounted the sponges or that the manufacturer had put one less sponge in the package than reported on the label, than it was that they had left a sponge in the patient.

One of the surgeons ordered another, single view of the abdomen in the PACU but the sponge was not identified because in that image it was partially overlying obscured by the patient’s spinal hardware.

In the meantime, the lead surgeon told the family that a sponge was missing, but that they were confident that it was not in the patient. The surgeon told the family it had probably left the OR on the bottom of someone’s shoe. However, the surgeon testified that he/she promised the family that they would remain vigilant in looking for the sponge.

Notwithstanding this promise and the patient’s slow post-operative recovery marked by ileum, the missing sponge was not mentioned a single time in the medical record in the next ten days. On multiple occasions the surgeons ordered abdominal imaging on to investigate the patient’s ileum and issues related to the patient’s otherwise slow recovery, but never informed the radiologists that a sponge had been missing at the end of their surgery. The sponge was visible on two of these x-rays, but was not identified by the radiologists. The radiologists testified at deposition that without knowing a sponge was missing, they could not reasonably have been expected to identify it.

Eleven days after the surgery, the surgeon ordered at CT scan to investigate the patient’s ongoing failure to improve and the CT scan revealed the presence of a radio-opaque sponge adhered to the small bowel. By that time the sponge had cause a closed loop small bowel obstruction in the vicinity of the umbilicus. The Plaintiff was taken to surgery to remove the sponge and repair the bowel. She suffered ongoing complications as a result of the small bowel obstructions from which she never recored. She died four months after the sponge was left in.

DEFENSE: The defense claimed the surgeons conducted a search for the sponge and did not see it and therefore it was reasonable to assume that the nurses had counted wrong or that the manufacturer had put the wrong number of sponges in the bag. The radiologists claimed that the sponge though visible in hindsight looked similar to the spinal hardware and therefore it was not negligent for them to fail to identify it as a sponge given that they were unaware a sponge was missing.

INJURIES: The patient died as a result of complication of the forgotten sponge four months after the initial surgery. She was hospitalized for all but 21 hours of those four months she was release eight days after the surgery to remove the sponge but was returned to the hospital by ambulance in critical condition within 24 hours. The patient underwent seven abdominal surgeries, which left her with only 92 cm of viable small bowel and a permanent colostomy. The wounds from these repeated surgeries did not heal well, requiring repeated debridement and wound vac changes. The patient was intubated and required assistance of a ventilator for 80 of the 82 days following readmission. Finally, on June 6th, a permanent tracheostomy tube was place because medical staff were unable to wean her from the ventilator.

During this time, the patient developed severe protein malnutrition and require enteral feedings through a gastrostomy tube or nasogastric tube. Her malnutrition was complicated by malabsorption caused by “short bowel syndrome” resulting from the surgical removal of most of her bowel. Ultimately, the patient’s nasogastric tube was removed, and she was restarted on TPN. She endured and extended period of time with bilateral chest tubes because of pleural effusions that developed during her post sponge removal care. She required treatment for generalized and intra-abdominal sepsis. She also suffered urinary tract infections and pressure sores during her struggle to recover from the complication of the forgotten surgical sponge.

During much of this time, the patient was awake and interactive. Because she was on a ventilator for most of the time, shew as force to communicate rough a speak valve in-line.

SPECIAL DAMAGES: Total medical expenses: $1,467,317.15

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Kimberly Kirkland and Randy Reis (Reis & Kirkland, PLLC)

NAMES/COUNTY: Anonymous v. Anonymous