Wednesday, August 29, 2012

Unskilled Diagnostic Laparascopy Leads to Lawsuit

Residents of Pittsburgh and Pennsylvania undergo diagnostic laparascopies each year. Diagnostic laparoscopy is a procedure that allows Pennsylvania doctors to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder. A surgeon makes a small cut below the belly button (navel) and inserts a needle into the area. Carbon dioxide gas is passed into the area to help move the abdominal wall and any organs out of the way, creating a larger space to work in. This helps the surgeon see the area better. A tube is placed through the cut in your abdominal area. A tiny video camera (laparoscope) goes through this tube and is used to see the inside of your pelvis and abdomen. Additional small cuts may be made if other instruments are needed to get a better view of certain organs.

While these procedures usually result in a complication-free outcome for patients, mistakes can occur. The case of Moschella v. Blatt is an example of a mistake occurring during a diagnostic laparascopy that led to a claim of medical malpractice.

The plaintiff, Moschella, contended that she underwent a diagnostic laparoscopy in which the defendant ob/gyn negligently attempted to lyse abdominal adhesions through the laparoscope without her consent, resulting in a torn ureter requiring surgical repair. The defendant argued that the procedure was properly performed, the plaintiff was fully informed, and that the ureter tear occurred in the absence of negligence.

Evidence established that on September 26, 1986, the plaintiff underwent a diagnostic laparoscopy performed by the defendant at which time dense abdominal adhesions were found. The defendant attempted to lyse the adhesions through the laparoscope. The plaintiff's expert ob/gyn testified that the attempt to lyse the adhesions resulted in tearing of the plaintiff's ureter which was not appreciated by the defendant, who discharged the plaintiff upon completion of the procedure. The plaintiff's expert testified that the defendant should have ceased the diagnostic laparoscopic procedure when he noted the dense adhesions and should not have lysed the adhesions through the laparoscope, but instead should have advised the plaintiff of the option of performing surgery to remove the dense adhesions by a laparotomy bikini incision.

As a result of the small tear in her ureter, the plaintiff was admitted to a hospital where she underwent an exploratory laparotomy and the surgical repair of the ureter. The defendant's expert ob/gyn testified that the defendant's actions in attempting to lyse the adhesions through the laparoscope were appropriate and that the ureter tear occurred in the absence of negligence. The defendant testified that he could not specifically recall discussing the procedure and the risks involved with the plaintiff, but that his normal practice was to do so with each patient. The jury found for the plaintiff in the amount of $ 75,000. The plaintiff also received an award of delay damages and post- judgment interest for a molded verdict of $ 113,950.

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1 comment:

  1. I facing the Abdominal Adhesions from last 5 months and I am always afraid of surgeries. After reading the article I relieved that I don't choose surgery for my treatment. Thank you for sharing such useful information.