When the Colon is perforated during a colonoscopy and standards of care are ignored, the doctor may be accused on medical malpractice. The following is a case in point.
A very healthy and active woman was referred to the defendant for a colonoscopy after a single incident of unexplained bleeding. After an essentially normal colonoscopy, plaintiff was sent to the day surgery recovery room for the standard minimum of 30 minutes. Plaintiff was to be monitored for vital signs and conditions in a specific list of criteria. The criteria, however, did not include pain.
While plaintiff was in the recovery room, she was under the care of a registered nurse. The nurse notified the defendant physician three times during the ensuing 3 hours of plaintiff’s nausea and vomiting and cramping pain. Upon the first notification, defendant ordered 4 mg of Zofran. This resulted in nausea and vomiting subsiding. However, the pain continued. In the second report, the nurse notified defendant that plaintiff’s blood pressure had dropped precipitously (to 90/55). Defendant issued no new orders. The abdominal pain and cramping continued, leading the nurse to make a third report to the defendant. No response to the third notification was recorded. Plaintiff was discharged approximately 30 minutes later in a wheelchair.
Plaintiff described her pain at the time of discharge as a 10+. She reported that the nurse had told her that she may need to come back to the emergency room later.
The next day, plaintiff made repeated calls to defendant’s office. None of these calls were answered. Finally, she went to the office of another surgeon. She was admitted to the hospital and was treated with antibiotics for a septic condition due to a perforation identified by plain film. She then underwent surgery. A perforation of a diverticula was identified, which had caused the peritoneum to fill with toxins. The surgeon resected her colon and performed a colostomy. It was approximately 8 months after this that a second surgery was performed to reverse the colostomy.
Plaintiff’s expert testified in court that defendant had breached standard of care by failing to address the significant drop in blood pressure, which reflected shock. The expert suggested this drop in blood pressure was probably the time of perforation and the beginning of leakage into the peritoneum. He further testified that defendant could have complied with the standard of care in one of several ways: ordering a plain film to rule out perforation, seeing the patient, asking another physician to see the patient, or giving the nurse orders to send plaintiff to the emergency room or to another facility. This expert noted that of a number of conditions that could be indicated by plaintiff’s symptoms, the most deadly, and thus the condition to rule out first, was a perforated colon. Plaintiff argued that defendant abandoned the patient. The court gave the duration of duty instruction over the defendant’s objection.
The defendant’s expert testified that defendant was not negligent and that the drop in blood pressure with the other symptoms did not warrant additional attention beyond monitoring. Defendant’s expert testified that the symptoms could have been explained by a reaction to the anesthetic.
The jury returned a verdict for the plaintiff in the amount of $1,057,500.
Medical malpractice can take many forms. An accident during the colonoscopy could result in a perforation of the colon. Had the defendant in this case recognized and addressed the problem immediately, the outcome might have been quite different. However, this defendant’s refusal to attend to the patient’s complaints and search for a cause of plaintiff’s distress was a failure to observe standards of care. This case of a colon perforated during a colonoscopy was very dangerous and could have been deadly.
If you or a loved one has been harmed by the negligence or wrongdoing of any medical practitioner, you may have grounds to file a medical malpractice action against the practitioner. Call Bettina Altizer to schedule a consultation (at no cost to you) to discuss the case and determine if further investigation is warranted.