Medical Negligence in Performing a Hysterectomy

Mrs. Murphy-wife, Mrs. Murphy, was a fifty-one (51) year-old female that sought gynecological treatment from Dr. Bernard, Dr. Bernard, during 2002 and 2003. The gynecological exams of July 2002 and February 2003 were noted by Dr. Murphy to be normal. During Dr. Bernard's July 2003 examination of Mrs. Murphy, it was believed that Mrs. Murphy had a cyst on her right ovary. A subsequent ultrasound revealed that Mrs. Murphy had an 8cm right ovarian cyst that required surgery.

On July 30, 2003, Dr. Bernard performed laproscopic surgery on Mrs. Murphy to remove her right ovarian cyst. The cyst was drained and the fluid sent for cytology. Mrs. Murphy was then discharged from the hospital later the same day.

On July 31, 2003, the Mrs. Murphy went to a neighboring hospital complaining of abdominal pain. A subsequent CT scan showed Mrs. Murphy had a large amount of free intraperitoneal air in a small amount of subcutaneous air compatible with recent laproscopic surgery and a focal fluid collection. Mrs. Murphy underwent an exploratory laparotomy where an incision was from above the umbilicus to the pubic area. During this time, it was discussed that her mid transverse colon had been punctured. This colon injury allowed fecal contents to spill into the abdominal cavity causing peritonitis, resulting in a colostomy, morbidity, and finally a reversal. Mrs. Murphy was eventually discharged from the hospital on August 8, 2003. She required a post-operative procedure on October 16, 2003 for closure of her loop colostomy.

At no time thereafter did Mrs. Murphy return to Dr. Bernard for medical treatment. Dr. Bernard, M.D., was diagnosed with metastatic lung cancer in September of 2003. He subsequently was found to be inoperable in view of the advanced nature of the poorly differentiated adenocarcinoma involving mediastinal and other nodes. Dr. Bernard stopped treating patients in December 2003 as a result of his diagnosis of metastatic lung cancer. He underwent chemotherapy but had a rapid downhill course and subsequently died in July 2004.

Plaintiffs' expert physician, a highly credentialed physician in gynecology, identified several areas where Dr. Bernards care and treatment of Mrs. Murphy fell below the acceptable standard of care.

First, Dr. Bernard failed to present or discuss informed consent with Mrs. Murphy prior to performing laproscopic surgery on her. Additionally, when Mrs. Murphy presented to the hospital for surgery, Dr. Bernard failed to explain the risks and benefits, as well as, alternatives to the proposed surgery. As discovered during deposition testimony, Mrs. Murphy was never told, prior to surgery, that injury may result to her bowel and/or other organs during surgery.

Secondly, because of Mrs. Murphy's multiple prior pelvic surgeries, including a cesarean section, a blind laproscopic procedure was not indicated and dramatically increased the risk of internal organ injury. An open laparoscopy or exploratory laparotomy were never offered to Mrs. Murphy and would have dramatically decreased any risk of bowel injury. As accepted in medical literature, if the patient has a history of multiple abdominal operations then an open laparoscopy is preferred since it reduces the incidence of both bowel and vascular trauma. Additionally, Dr. Bernard failed to explore the abdomen and pelvis upon entering, during, and prior to closing Mrs. Murphy, as accepted practice.

Thirdly, Dr. Bernard failed to identify the internal landmarks by palpation of the abdominal wall prior to inserting the Verres needle. He also failed to use counter traction to elevate the umbilicus and abdominal wall away from the internal viscera and vasculature, placing Mrs. Murphy at increased risk for internal organ injury.

Additionally, Dr. Bernard did not explore the abdomen and pelvis prior to removing the laproscope, and thus failed to diagnose the injury to the transverse colon.

Lastly, as opined by Plaintiffs' expert, Dr. Bernard undoubtedly had micrometastatic disease in July of 2003 that affected his everyday practice and surgery. Dr. Bernard's prognosis was very poor in September of 2003 as he already had these cells in circulation and he was, although not clinically staged as Stage IV, his disease had spread through out his body. As a result, Mrs. Murphy suffered from Dr. Bernard's treatment of her and will continue to suffer multiple complications related to the surgery, as well as, subsequent surgeries.

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