Attorney and partner, Michael Maggiano has resolved at trial a case for a 56-year-old woman for a failed laparascopic procedure resulting in a gastric rupture, due to failure to properly evaluate signs and symptoms of the condition.
If you or someone you know has been injured due to medical malpractice, an experienced medical malpractice attorney at Maggiano Law can help you receive the compensation you deserve. Call (201) 890-4838 for a free consultation.
In September 2012, Plaintiff visited the offices of a Bariatric Surgeon to consult on weight loss procedure that would enable her to safely lose weight. The surgeon recommended that the plaintiff undergo a lap band procedure.
In December 2012 Plaintiff underwent a laparoscopic lap band placement surgery. Approximately eight months Plaintiff began to experience abdominal complaints and expressed these to her surgeon. In September 2013 she suffered severe bouts of abdominal pain, nausea and vomiting while at work. She called her surgeon and left a message regarding her problems. As conditions became worse an ambulance was summoned and she was transported to a local hospital near her place of employment for evaluation. While being evaluated, her surgeon called on her cell phone and asked her to immediately come to his office and he will evaluate her. She apologized to the Emergency Room physician and expressed that she felt she should heed her surgeon and immediately go to his office. The ER physician stated he wanted to do a chest x ray and that if she left it was against his advices. Later that afternoon she was seen by the defendant Bariatric Surgeon at his medical offices where Plaintiff shared with him her complaints of nausea, abdominal pain and vomiting of one week. The defendant surgeon released some pressure from her lap band and discharged her home again expressing encouragement that she was losing weight, yet not performing any radiological diagnostic testing to evaluate the root cause of her one-week episode of three well known signs and symptoms of a slipped lap band and possible gastric perforation.
In the following months of October through December the plaintiff experienced similar ongoing complaints of abdominal pain and food intake issues which she communicated to the Bariatric Surgeon.
In the second week of December 2013, she was seen urgently at a local Emergency Department where a chest x ray showed that she had a slipped lap band. Since her surgeon did not have privileges at that hospital, he asked that his patient be transported to the hospital her performed surgery in order to evaluate the condition. An Esophagram with contrast material was performed which showed the lap band slipped from a one o’clock position to a five o’clock position causing severely distended stomach and complete blockage at the level of the lap band. Surgery was performed for removal of the band. During the surgery Ischemia was found on both sides of the stomach wall. While the gray areas of ischemia improved significantly according to the defendant surgeon, the stomach wall did not otherwise return to its normal contour and remained distended as was identified in subsequent CAT Scans following her gastric rupture five weeks later. During her three day hospitalization for the lap band removal, Plaintiff’s vital signs showed a high White Blood Count of 15. 6 and 15.3 over her normal of 7, a high heart rate known as Tachycardia going as high as 129 with a 116 reading at discharge against a normal Heart Rate of 80 with a temperature of 100.5 and a high lactate level of 4.
The defendant surgeon was not at the hospital on day of discharge but authorized her discharge on a finding that her abdomen was soft and she did express complaints. It was documented that she had been on morphine through her stay and was also placed on two antibiotics.
Plaintiff was never informed of her abnormal vital signs by any physician. At trial she testified that had she been so informed she would have demanded additional testing to find the root cause of the abnormal signs and further demanded not be discharged until a determination was made.
Following her discharge from the hospital, Plaintiff called her surgeon the next day because of on going complaints. She was given an appointment for the following week for examination and staple removal. At the post op exam, the plaintiff complained of abdominal pain. The defendant surgeon laughed and said, “Of course you have pain, you just had surgery.” Plaintiff, over the next several weeks, called her surgeon with complaints of abdominal pain. The surgeon denies that these communications took place. The plaintiff produced her phone records and those of her employer showing the exam times that calls were placed and received to and from her surgeon’s office in support of her contention denied by the surgeon.
In the first week of January 2014 following several calls to the defendant surgeon’s office with continuing abdominal complaints, the defendant without speaking to Plaintiff on the phone or calling her in for an exam prescribed AcipHex ( a medication for acid reflux) and entered a new diagnosis in the patient chart of Esophageal Reflux without speaking to her directly or calling her in for an examination.
Plaintiff continued to experience abdominal pains which eventually grew to such intensity that she was taken by ambulance in the early morning hours of January 23, 2014 to a major local hospital where she was diagnosed as being septic and admitted to the hospital. A CAT Scan of the Abdomen and Pelvis with Contrast revealed a gastric perforation with food debris and free air in areas of the peritoneal cavity with evidence of peritonitis. The plaintiff was ordered for emergency surgical intervention in an attempt to save her life. She was required to undergo multiple surgeries during her hospitalization due a severe gastric rupture. It was clear that the distended stomach eventually ruptured. There was evidence that the condition had been chronic for at least a number of weeks probably resulting from the slipped band issues identified 5 weeks earlier. Upon close examination of the Cat Scan images showed that the stomach distention persisted, and, the rupture appears to have started in the area of fundus and along the upper area of the greater curvature of the stomach. Following two major surgeries to repair the stomach and eleven wash outs, she was discharge on in late March 2014. Since then she has suffered the consequences of a modified stomach, resultant dramatically modified eating and dietary requirements, persistent abdominal issues including dumping syndrome and diarrhea, impact on her endocrine system causing early and late hypoglycemia, and a number of other issues impairing her home and work life.
The plaintiff’s experts contended that the vital signs pointed to two potential deadly conditions that should have been on the Defendant’s Differential Diagnosis. The first was a Pulmonary Embolism. The defendant performed two EKGs and nothing more. The second consideration was Peritonitis caused by a gastric perforation and persistent ischemia at the stomach wall suffering the serious distention. The Plaintiff’s experts contended that prior to discharge a Cat Scan with contrast should have been performed to further evaluate the persistent symptoms. If the problem was a gastric leak surgery would seal it. If the distention was persisting causing erosion of the stomach wall then further surgery was required to reinforce the stomach wall. Neither took place.
A CAT Scan immediately ordered on Plaintiff’s readmission in fear of a rupture showed clear evidence that a gastric rupture had taken place.
The defense took the position to blame the matter on two intervening supervening events: 1. Plaintiff must have taken NSAIDS causing an ulcer in the area of the Gastric Cardia and 2. The surgeon called into the matter to explore and repair mishandled repairing a minor ulcer and turned the matter into a medical catastrophe. The defense bariatric surgeon so much as contended that the subsequent surgeon’s OP report describing in detail findings of a severe gastric rupture was “Manufactured Fantasy.”
Plaintiff’s counsel enlisted the services of the medical illustrators at Medi Visuals to work with Plaintiff’s surgical and radiology experts in order to demonstrate the evolution of the pathology from Plaintiff’s untimely discharge from one hospital in early December 2013 to the medical catastrophe of late January 2014. Particularly effective were illustrations demonstrating what was depicted in the Esophagram showing the displaced band, severe stomach distention and blockage impairing blood flow through the stomach walls. An illustrative tutorial showing the blood flow system throughout the stomach and how when impaired created tissue ischemia and eventual stomach wall erosion provided a helpful set of visuals to appreciate how a well-known complication without timely treatment led to a medical disaster. Other exhibits showed vividly showed the radiological evidence of the subsequent CAT Scan pointing to a walled off gastric perforation attributed to the slipped lap band and eventual rupture of the stomach wall.
All in all, more than 30 exhibits were created to demonstrate the evolution of the pathology working off the available radiological evidence as well as illustrations of the surgical repairs and related interventions.
In New Jersey a medical negligence case cannot settle without the surgeon’s consent to do so. Following the presentation of preliminary legal arguments, Opening Statements, testimony of four treating physicians and during the testimony of the plaintiff, the matter was settled by way of a confidentiality agreement. The plaintiff while recognizing no money can give her back her prior life expressed great satisfaction with the resolution of the case in her favor and the legal services provided by the law firm.
While the terms of the settlement are confidential the Plaintiff has expressed the following in a review she placed on Google.
The Plaintiff while maintaining confidentiality of the settlement terms publicly expressed that after thirteen surgeries, multiple procedures and over two months in the ICU, all due to the negligence of one of my doctors, I was referred to Michael Maggiano to pursue a medical malpractice case. I had never been involved in a lawsuit in my life and from the moment I met Michael and his team at Maggiano, DiGirolamo & Lizzi I knew I was in extremely competent hands. Michael is the best lawyer you could imagine – he is intelligent, detail oriented, extremely knowledgeable and passionate about his work and his clients. Michael is a consummate professional and I will forever be impressed by, and indebted to, both him and his team. The entire staff at Maggiano, DiGirolamo & Lizzi is friendly, welcoming and do everything to make their clients comfortable. I would like to specifically thank Linda Reid and Bernadette Elbert who both went above and beyond to make my experience as comfortable as possible, from including me in all detailed correspondence to sending encouraging texts and even giving hugs when needed. Thank you so much to everyone at Maggiano, DiGirolamo & Lizzi – I highly recommend this law firm to anyone looking for a compassionate team to handle a personal injury claim.
If you or someone you know has been negatively effected by a faulty medical procedure, you need the help of an experienced medical malpractice attorney. Call Maggiano, DiGirolamo, and Lizzi P.C. at (201) 890-4838 to protect your rights and to receive the compensation you deserve!