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Patient, 25, with undiagnosed bowel obstruction dies during surgery.

Byline: Mass. Lawyers Weekly Staff

The plaintiff's decedent was 25 and married with no children when she died from aspiration during anesthesia induction as a result of vomiting due to an undiagnosed bowel obstruction. She had previously undergone an appendectomy and a gastric bypass with approximately 200-pound weight loss.<br />The patient presented to the emergency department with complaints of abdominal pain in her lower abdomen, nausea and vomiting for several days. Her abdomen was tender but soft, without guarding or rebound. She was admitted for further evaluation, hydration, and control of pain and nausea.<br />The following day, Friday, she was alert, oriented and able to follow commands, but she was drowsy. She was afebrile with a WBC of 7.2. Her diet included clear liquids. The plan was for her to undergo laparoscopic cholelithiasis on Monday.<br />Over the weekend, she was alert and oriented, afebrile, with no signs or symptoms of infection. Her vital signs were stable and she was voiding. She was ordered for clear liquids, but had persistent nausea and vomited bilious matter. She was able to ambulate independently. A progress note reflected that she was in no acute distress.<br />On Monday, the patient was taken to the operating room for diagnostic laparoscopy. She was given propofol to begin induction of anesthesia and immediately aspirated massive amounts of feculent emesis. The surgery was canceled, and she was transported to the surgical intensive care unit in critical condition.<br />Her condition continued to deteriorate. She was given comfort measures only, and died a few days later. An autopsy confirmed her cause of death was aspiration during anesthesia induction.<br />The plaintiff claimed the defendants failed to recognize and appreciate the patient's increased risk factors for, and signs and symptoms of, a bowel obstruction; failed to perform abdominal imaging to rule out a bowel obstruction; and failed to properly place a nasogastric, or NG, tube prior to surgical exploration.<br />The defendants denied liability and contended that it was a tragic outcome but not due to any negligence. They further contended that placing an NG tube was not possible due to her prior gastric bypass.<br />Action: Medical malpractice<br />Injuries alleged: Death<br />Case name: Withheld<br />Court/case no.: Withheld<br />Jury and/or judge: N/A (settled)<br />Amount: $3 million<br />Date: January 2017<br />Attorneys: Andrew C. Meyer Jr. and William J. Thompson, of Lubin & Meyer, Boston (for the plaintiff)

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Title Annotation:Massachusetts
Publication:Massachusetts Lawyers Weekly
Date:Jun 28, 2018
Words:417
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