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In this medical malpractice action, the plaintiff alleged that he suffered lower limb amputations from septic shock resulting from the negligence of the defendant general surgeon in failing to create a proper diversion of fecal stream when he found a perforation of the sigmoid colon. The plaintiff also alleged that post-surgery, the staff of the defendant hospital failed to notify the co-defendant surgeon when signs and symptoms revealed the plaintiff was septic. The defendant surgeon disputed that he was negligent and maintained that he chose a proper procedure and performed it within the required standard of care. The co-defendant hospital contended that the plaintiff’s post-surgical signs and symptoms were reasonably attributed to the pain medication he was taking. 

The 47-year-old male plaintiff was employed as a foreman in the production department of a local newspaper company. He underwent surgeryfor a colo-vesical fistula from diverticulitis. The surgery involved a resection of the colon with an end-to-end anastomosis. Following the surgery, the plaintiff developed an abscess that was drained over a two- month period. He entered the defendant hospital through the emergency department for severe abdominal pain and underwent exploratory surgery the next day. The surgery exposed a perforation of the colon in or near the anastomosis and the defendant general surgeon was called. 

The plaintiff contended that the defendant general surgeon could not close the colon perforation and negligently failed to perform another resection or a left-side colostomy; but rather, created an ileostomy and left the colon with stool content. Post-surgically, even with an epidural, the plaintiff had intense pain that was managed with significant pain medications. Within hours of the defendant’s performance of the ileostomy, the plaintiff claimed that he suffered low blood pressure, tachycardia and other signs suggesting sepsis, and referred pain suggesting possible peritonitis. 

The plaintiff alleged that the defendant hospital’s pain management specialist and nursing staff never notified the co-defendant surgeon until the plaintiff was in serious condition and going into shock. The plaintiff was transferred to another hospital where a non-party surgeon documented two liters of stool in the plaintiff’s abdominal cavity and seven subsequent surgeries were performed.

The plaintiff s extremities were ischemic from the septic shock and the condition could not be reversed. The plaintiff underwent bilateral trans-tibial below-the-knee amputations of lower legs. His doctors also reported that the ileostomy may not be reversible.

The defendant surgeon’s expert testified that the defendant surgeon took the correct option in treating the colon perforation. This expert opined that the plaintiff’s fecal peritonitis began when the anastomosis came apart, but that occurred post-surgically because of low blood pressure and was not the result of any negligence on the part of the defendant doctor.

Greg Palumbo