Contemporary Surgery

GI hemorrhage causes death after esophageal mass is removed

  Liable or not? You decide

THE PLAINTIFF

A 67-year-old man had an operation for a benign mass at the base of the esophagus.

CASE FACTS

The patient had ceased taking warfarin, but an INR before the operation was abnormal.

POSTOPERATIVE COURSE

A day after the operation, the patient’s condition deteriorated. An exploratory laparotomy identifi ed a massive gastrointestinal hemorrhage. The patient ultimately required amputation of both legs, became bedridden, and died of multi-organ failure 10 months postoperatively.

PLAINTIFF’S CLAIM

The surgeons should not have performed the initial surgery because the abnormal INR showed the patient was at signifi cant risk of bleeding.

DOCTOR’S DEFENSE

The operation was indicated and performed properly. The massive hemorrhage was a known complication.

Case excerpted from Medical Malpractice Verdicts, Settlements and Experts, with permission of the editor, Lewis Laska, Nashville, TN (www.verdictslaska.com).