Sommers Schwartz attorneys Matthew L. Turner and Michael D. McCullough filed a medical malpractice wrongful death action claiming that the decedent died from a failure to locate and repair a bowel perforation during and after an endoscopic procedure. The defendants named in the wrongful death lawsuit were a gastroenterologist, general surgeon, radiologist, two internists, and the medical facilities that employed them.

The decedent, a 57-year-old married woman, was admitted to the defendant hospital to undergo an Endoscopic Retrograde Cholangiopancreatography (ERCP) to diagnose and treat abdominal pain. An ERCP procedure is used to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas, combining an x-ray and upper gastrointestinal endoscope.

The defendant gastroenterologist was unaware that he had perforated the patient’s bowel during the procedure. The plaintiff alleged the defendant gastroenterologist negligently performed the ERCP using poor radiologic guidance while employing a high-risk technique with blind utilization of a needle knife to enter the common bile duct.  The poor technique resulted in the gastroenterologist causing the perforation and failing to recognize the perforation during the procedure.    

The decedent developed intraoperative and postoperative hypotension and clinical instability, which indicated complications arising from the procedure. Perforation, cholangitis, and bleeding are the likely causes of such situations, requiring timely evaluation and treatment. The decedent was given repeated doses of Neo-synephrine and ultimately placed on a vasopressor drip to manage the hypotension.

The plaintiff contends that despite the decedent’s deteriorating condition after the procedure, the defendants did not diagnose the bowel perforation in a timely manner.  Two chest x-rays showed free air, which is highly suggestive of a bowel perforation.  The radiologist that interpreted the x-rays failed to report the free air.  The gastroenterologist and the general surgeon failed to order a CT scan with oral contrast or methylene blue through a nasogastric tube, which is the best study to diagnose a bowel perforation.  The general surgeon also failed to convert the laparoscopy to a  laparotomy when the laparoscopy did not identify the perforation.   

The decedent died from sepsis and multiple organ failure directly caused by the bowel perforation.