Severed portal vein during laparoscopic liver resection...

by A
(USA)

My husband had a laparoscopic liver resection. During the procedure the portal vein was severed, causing massive bleeding. In the postoperative talk with family, the surgeon said he wish he would have converted to open sooner, as my husband had profound hypotension and received 6 units blood during procedure.

The surgeon stated that postop he would be worried about a bowel infarction due to the profound hypotension and blood loss. Postoperative days 2-3 my husband, after receiving additional blood, had a reaction called TRALI (Transfusion Related Acute Lung Injury), resulting in being placed back on the ventilator.

On about postop day 7, my husband had a spike in temperature and white blood cell count. He was started on a antibiotic. Imaging was ordered and showed abscess formation and also that the liver on either side of the wedge resection had died. The surgeon told family that he should have surgery for debridement and evacuation of abscess.

Since it was late Friday afternoon the surgery was planned for Tuesday. However on Monday husband was showing signs of improvement so surgery was canceled by the surgeon. Instead, a drain was placed, which had output of a lighter greenish fluid immediately. My husband continued in critical condition.

After approximately a month, infectious disease was called in, and they started triple antibiotic coverage. Approximately within this same time frame he was started on hemodialysis as his kidneys shut down. During the next 30 days his right upper quadrant incision opened and drained copious amounts of dark fluid and clumps of tissue like material that smelled like bowel.

The surgeon stated as long as it was draining it was fine and an ostomy-type bag was placed over the open incision. My husband continued to show signs of sepsis and was not taken to surgery for exploration and washout for at least another 30 days. By that time all tissue was very friable with loss of another 4 units of blood.

Ten days after the surgery my husband finally passed. This was after 72 days of fighting for his life. I question if the surgeon would have acted sooner with the exploration/debridement/washout that the profound sepsis and resulting multisystem failure would have been diverted?

Would this be a case of physician neglect and wrongful death? Thank you.

Visitor Question:
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ANSWER for "Severed portal vein during laparoscopic liver resection...":

A (USA):

From the facts you present, medical malpractice may have occurred. The admission by the primary physician may be evidence supporting a claim for malpractice. However, just because during the procedure the portal vein was severed, causing massive bleeding, doesn't necessarily mean malpractice occurred - even if the physician said "he wish he would have converted to open sooner."

For the purposes of your claim, medical malpractice is defined as an action or omission by the doctor in which the treatment he provided fell below the accepted standard of practice in the medical community, when such act or omission resulted in injury or death to your husband.

The determinative question in your claim of medical malpractice is whether the doctor's act in severing the portal vein fell below the standard of care of other doctors in the community. Was the severing of the portal vein a possible result of the surgery, according to other similar type surgeries? If so, then malpractice may not have occurred.

Gather copies of all your husband’s medical records and bills, along with receipts for out of pocket expenses for medications, etc. Search for attorneys with substantial experience in medical malpractice. Most will not charge for an initial office consultation.

The attorneys will review the case, and probably have the records reviewed by medical experts. If it is the opinion of a medical expert that malpractice occurred, then the attorney will likely accept the case.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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