What you should know about the most common surgical errors

 

Surgeons often mistake serious complications for being a normal part of recovering from an operation

 
October 31, 2018

One of the most common problems I’ve seen in surgical healthcare is surgeons mistaking a complication for a normal recovery.

For example, in one case, a College Station woman went to the emergency room because of sudden, severe abdominal pain. The emergency physicians quickly figured out that she had appendicitis and needed her appendix removed to avoid the risk of a rupture. She was taken to the operating room for a laparoscopic appendectomy and then discharged on the same day.

The day after she got home, the hydrocodone that she was prescribed didn’t relieve the severe pain that she was experiencing. Her family members called the surgeon’s office five times in less than a 24-hour period out of concern for the pain. The surgeon never spoke to them, but his nurse advised adding over-the-counter ibuprofen for her pain and giving her a laxative or an enema.

After the fifth call, they took her back to the hospital emergency room (ER). The ER physician ordered lab work, which showed that she had systemic inflammatory response syndrome (SIRS), which meant she likely had a serious infection related to the surgery and would probably develop sepsis.

The ER doctor and the surgeon thought that she was just having a rough but normal recovery. They didn’t order appropriate diagnostic radiology studies, like an abdominal MRI, to investigate what was going on. As a result, there was a significant delay in learning that the surgeon had accidentally perforated her colon during surgery. By then, she was in septic shock, and it was too late to save her life.

There are errors in all phases of surgical care

A major medical malpractice insurance carrier for physicians, the Doctors Company, did a five-year review of closed claims against general surgeons. Their review identified the events that happen before, during, and after surgery that cause patients harm.

A Boston study that had similar findings concluded, “Surgeons and their clinical teams are found responsible for errors across the entire surgical timeline—flawed decisions to operate, technical errors in the OR [operating room] and postoperative mismanagement during recovery. Alarmingly, most of the scenarios are preventable.”

Common surgical problems leading to medical malpractice lawsuits

According to the Doctors Company study, medical malpractice claims stemming from postoperative (after the surgery) care had these common injuries or outcomes:  death (46% of claims), postoperative infections (not including abscesses, 29% of claims), punctures or lacerations (14% of claims), additional surgery needed (12% of claims), prolonged hospitalization (12% of claims), amputation or mobility dysfunction (9% of claims), tissue necrosis (tissue death, 9% of claims), and abscesses (an accumulation of infected pus, 5% of claims).

Their study also found that a common error was failing to properly monitor patients who were placed on opioid painkillers after surgery. These powerful pain medications can cause a patient to go into respiratory distress.

This reminds me of a case that I handled a few years ago for the family of a very active elderly lady who was placed on strong opioid painkillers after a surgery on her neck. The surgeon, hospitalist, and nurses didn’t pay attention to the fact that the medication was causing her to get sleepy. She developed respiratory depression, vomited, and aspirated the vomit (meaning that it entered her airway), which led to aspiration pneumonia that took her life.

In addition, many post-surgical patients are immobilized or bedridden, which puts them at an increased risk for deep vein thrombosis (DVT), which can lead to pulmonary embolisms and death.

I thought it was interesting that the study found that most of the post-operative problems leading to medical negligence lawsuits happened in the hospital—a whopping 62% of all claims. I’ve often felt, when reviewing certain cases, that patients would have been better off going home, rather than staying in the hospital to recuperate. That way, if a problem did occur, they could return to the ER and get immediate attention.

Common types of negligence

The most common allegations leading to lawsuits, based on the study, include:

· Making a wrong or delayed diagnosis or failing to diagnose (35% of all claims)

· Improper management of treatment (28% of all claims)

· Improper performance of treatment or procedure (7% of all claims)

· Delaying a return to surgery when it was needed (4% of all claims)

· Flawed management of medications (4% of all claims)

Other frequent findings of surgeon negligence ring true from my experience in handling medical malpractice cases. Here are some of them:

Patient assessment issues include failure to order diagnostic tests and consider available clinical information, plus overly relying on negative findings even though a patient continues to experience symptoms.

Miscommunication among medical professionals, including surgeons, physicians, and nurses, is a prevalent problem. This includes not notifying one another about a patient’s condition and simply declining to read the medical record. I recently deposed a spine surgeon who practices at Houston Methodist Willowbrook Hospital. He admitted that it’s not his practice to review medical record entries made by registered nurses, physical therapists, or occupational therapists. It seems like he just waits to randomly run into them in the hospital to have a quick chat.

Technical performance during a surgical procedure is always concerning. This includes a poor technique the causes a bad outcome, accidentally leaving surgical supplies in the patient’s body, and operating on the wrong body part.

We are here to help

If you or a loved one has been seriously injured 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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