What happens when a surgeon cuts too deep?

 

Dangerous surgeons go too far without explaining to their patients all the treatment options

 
October 23, 2018

Experienced Texas medical malpractice attorneys spent a lot of time consulting with medical experts to investigate negligence and wrongful death cases. Today, I had an interesting conversation with an internationally-recognized expert abdominal radiologist.

I’m working on a case where a general surgeon operated on a patient who had an obstructive mass in her colon. When I say “obstructive,” I mean that it had her blocked up such that she could not go to the bathroom.

She was initially diagnosed from an abdominal CT scan that was performed without contrast. The lack of contrast means that it was difficult to see how close the mass got to the blood vessels.

After a colonoscopy, the gastroenterologist diagnosed the mass as cancerous. He referred the patient to a general surgeon, who took her to the operating room a few days later.

It’s clear that the surgeon needed to take her to surgery. This patient couldn’t go to the bathroom because her colon was blocked. At a minimum, the surgeon needed to redirect the fecal path, perhaps by placing a colostomy bag.

Once the surgeon started the procedure and saw the size of the cancerous tumor blocking her bowel, he had to make some critical decisions.

The surgeon could have chosen to address the urgent problem by creating an intestinal path to a colostomy bag. He could have ended the surgery there and then referred her to a medical oncologist, who could treat her colon cancer with chemotherapy.

In addition to this, the surgeon could also have safely removed part of the obstructive tumor, while staying away from the important blood vessels in the area that supply vital organs.

When I explained to the abdominal radiologist that the inexperienced surgeon chose to cut even deeper into the patient’s colon and adjacent fat and, in the process, cut and damaged the superior mesenteric vein, he was surprised. Like the general surgery expert that Painter Law Firm hired to review this case, he felt that the surgeon should have ordered a CT scan of the abdomen, with contrast, which would have provided a better view of what he was getting into.

Unfortunately, this poor lady suffered significant damage to nearly every vital organ in her abdomen. She eventually died from her injuries.

One of the things that sticks out to me in this case is the lack of a proper conversation between the surgeon, patient, and her family—before she was taken to the operating room—about her options. In both law and medicine, this type of required conversation is called informed consent.

As patients, we depend on medical professionals to diagnose our conditions and recommend treatments. Sometimes an illness or condition has more than one treatment available. During a proper informed consent conversation, the doctor should explain the pluses and minuses for each potential treatment, as well as the benefits and dangers of doing nothing.

In this patient’s case, a competent surgeon would have advised her that she had a bowel obstruction caused by a cancerous tumor. Without surgery to address the bowel obstruction, she would die.

The surgeon should have informed her that she had some different options on what to do beyond that. One option would be chemotherapy. Her type of colon cancer was highly treatable and had a high survival rate with chemotherapy. She could choose to go that route without further surgical intervention at that time.

Another option would be to have the surgeon remove part of the tumor. Yet another option would be to have the surgeon remove part of the tumor and any lymph nodes affected by the cancer. Both of these options, though, only prevent the added risk of a potential injury to blood vessels or vital organs, with no real benefit beyond treatment by chemotherapy alone.

The problem gets down to this—how can a patient make an informed choice when she is given no choice? I think a reasonable patient would have turned down the extra surgical option, in favor of chemotherapy. If this lady had been given that choice, our medical experts say that she’d still be alive today.

We are here to help

If you or a loved one has been seriously injured or even died because of surgical, medical, or hospital care, then the experienced medical malpractice attorneys at Painter Law Firm, in Houston, Texas, are here to help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.

All consultations are free, and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case. We handle cases in the Houston area and all over Texas. We are currently working on medical malpractice lawsuits in Houston, The Woodlands, Sugar Land, Conroe, Dallas, Austin, San Antonio, Corpus Christi, Bryan/College Station, and Waco.

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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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