A 25-year-old patient recovered damages due to a severe leg injury which was caused by a surgeon’s negligent care provided during an operation to remove the plaintiff’s inflamed appendix. As well, the surgeon did not obtain informed consent from the plaintiff for the procedure (and in fact performed the wrong operation to remove the appendix).
The plaintiff arrived at the emergency department of the Oakville hospital complaining of abdominal pain and nausea. The plaintiff communicated this to the attending surgeon. Initially, the surgeon did not indicate what the cause of the plaintiff’s severe abdominal pain was.
The surgeon ordered an ultrasound for the following day and the patient was sent home. The following morning, the plaintiff had an ultrasound which revealed that the plaintiff had an inflamed appendix. The surgeon informed the plaintiff that the appendix needed to be removed and that the procedure was simple, requiring only a small incision.
The surgeon’s care in this instance was negligent, as the diagnosis of appendicitis should have been made upon the plaintiff’s initial consultation. At a minimum, due to the presence of severe abdominal pain and an elevated white blood cell count, the patient should have been kept for observation. The fact that the ultrasound suite was closed was not a valid reason to send the patient home.
Shortly before the procedure was to be performed, a nurse asked the plaintiff to sign a consent form.
The plaintiff refused to sign the form, as no one had explained the procedure. The plaintiff then filled out a questionnaire as requested. The plaintiff was again asked to sign the consent form, at which time the plaintiff had no choice but to sign the form. The informed consent form did not mention the possibility of an open appendectomy. It was the responsibility and obligation of the surgeon to explain to the patient the type of procedure which was going to be used and the risks associated with it.
Later that day the surgeon performed a laparoscopic appendectomy. Unfortunately for the plaintiff, the surgeon selected the wrong procedure — a laparoscopic appendectomy – to remove the inflamed appendix. In light of the fact that the plaintiff was very small and thin, the surgeon should have conducted an open appendectomy surgery instead.
While conducting the improper laparoscopic procedure, the surgeon negligently sliced the right common iliac artery, which caused the patient to become hypotensive (abnormally low blood pressure) and caused a hematoma (localized collection of blood outside the blood vessels). This error turned a routine appendix removal into a life threatening, limb-salvaging situation. To make matters worse, after committing the error, not only did the surgeon not know how to properly repair the common iliac artery which was sliced, the surgeon did not have the proper equipment to repair the mistake. Therefore, valuable minutes were lost. Next, since the surgeon was not competent to fix the significant error, other doctors had to try to stabilize the plaintiff while they waited for a vascular surgeon to arrive to fix the first surgeon’s error. This contributed to the thrombosis (a blood clot inside a blood vessel which obstructs the blood flow to the circulatory system) of the first repair and the need for a re-operation with a graft.
The hospital was also negligent, as it did not maintain appropriate informed consent policies, it did not train its operating room nurses with regards to having the proper equipment available during laparoscopic surgery and it did not ensure that its surgeons had the adequate credentials to perform a laparoscopic appendectomy (including written documentation in the files).
The plaintiff sustained substantial permanent impairment of the peripheral vascular system (including poor blood circulation). These injuries forced modifications of the plaintiff’s lifestyle, the need for medical services and assistive devices, and depression and anxiety. The plaintiff continues to be at risk or thrombosis and the progressive development of peripheral vascular disease. Both of these risk factors stem from the bypass surgery which had to be performed when the common iliac artery was injured.
Sommers Roth & Elmaleh Professional Corporation has over 40 years of experience in medical malpractice litigation in the Greater Toronto Area (GTA), Ontario, and across Canada.
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