Patient killed by surgical error of family claims


Doctors ignore post-surgical complaints and patients die, plaintiffs say

A Georgia jury awarded $ 3 million to the family of a woman who suffered a fatal bowel injury during surgery at Northeast Georgia Medical Center in Gainesville, according to a story at the Daily report.

On May 3, 2016, Frances Mitchell went to the medical center to remove a pelvic mass by laparoscopic abdominal surgery. His surgeon was Andrew Green, MD, a gynecologic oncologist and member of the Group of doctors from northeast Georgia.

Shortly after returning home, Mitchell began to experience pain. A family member contacted the hospital for advice and was asked to feed the patient’s broth and continue walking. Her pain worsened, however, and she was taken by ambulance to the emergency department (ED).

Back at the hospital, she underwent an inconclusive computed tomography scan and blood tests that indicated she was septic. Its temperature was slightly elevated, an increase of 2 ° with respect to the admission. However, she was sent home.

Over the next few days, Mitchell’s family called the hospital several times because his condition did not improve. On May 7, 4 days after his surgery, he died. An autopsy performed by the Georgia Bureau of Investigation listed the cause of death how “peritonitis due to a perforation of the small intestine “.

In 2017, Mitchell’s mother and her two older children sued the medical center, Green, for her medical consultation, an ED doctor and several other defendants. (The lawsuit was first filed in the State Court of Georgia and then re-filed in the Superior Court of Georgia).

Plaintiffs’ claim alleged that during the May 3 laparoscopic procedure, Green pierced Mitchell’s small intestine, but did not properly diagnose or repair his mistake. The lawsuit further alleged that Green and the other defendants were negligent in their post-surgical care. The alleged negligence included sending Mitchell home after he returned to the hospital, despite his damaged intestine; stop responding to multiple family complaints about your condition; and not documenting these complaints, as required by hospital policy. (Doctor ED was later removed from the suit.)

Green and his fellow defendants denied each of the charges. In addition, both the medical center and the group of doctors said they were “improper parts” of the lawsuit.

At trial, the defendants ‘lead counsel, M. Scott Bailey, argued with the plaintiffs’ key statement: “We absolutely deny that the intestine was perforated during the surgery. We believe the partial injury he suffered was [Mitchell’s] the intestine became a perforation afterwards. We believe that the pathological evidence supported this and that the plaintiffs ’theory that this injury occurred at the time of surgery has no medical or common sense sense.” He also denied that his clients had been negligent in their post-surgical care.

The jury disagreed, taking only 5 hours to return with a $ 3 million lawsuit in favor of the plaintiffs.

Currently, the defense contemplates an appeal. Among other things, it is questionable whether Mitchell’s mother had a “right,” that is, the legal right, to bring the lawsuit first, since Mitchell was married at the time of her death and her husband was still he was alive. .

“We believe Georgia law supports our position that he was the right plaintiff,” defense attorney Bailey said.

Artificial intelligence: great! But here are the risks of malpractice

Artificial intelligence (AI) opens up new imaging possibilities for radiologists and their practices, but it also initiates a new world of civil liability risks, as an article published last month a Skeletal Radiology i summarized inside Health images he argues.

The authors of the article are H. Benjamin Harvey, MD, JD, a neuroradiologist at Massachusetts General Hospital, an assistant professor at Harvard Medical School and a graduate of Harvard Law School, and Vrushab Gowda, a JD candidate in college. of law. They outline four areas of potential responsibility involving AI-assisted musculoskeletal imaging, using hypothetical examples to illustrate their points. Three of the four areas directly affect physicians and their practices.

General negligence

In Example 1, a radiologist uses an artificial intelligence tool to interpret a pelvic x-ray to assess the condition of an elderly patient after a fall. The program returns a negative reading and the patient is discharged based on that reading. After discharge, however, the patient develops avascular necrosis of the femoral head, which requires arthroplasty. Harvey and Gowda ask: What is the doctor’s risk of malpractice?

His answer takes into account the various aspects of negligence, including causation. Because the physician in this case relied solely on AI to arrive at his diagnosis, his actions could be interpreted as a breach of care that directly caused the patient’s injuries. (The theory of negligence requires this kind of causal link between duty and result.)

For this reason, the authors claim, a physician in these circumstances who wants to mitigate his risk of malpractice would do well to take a simple precaution: first, read the hip x-ray without AI assistance and then use the AI ​​program to confirm or contradict the initial “manual” reading. That way, if a discrepancy occurs, doctors can rely on their “own executive judgment, consult with colleagues, and follow established protocols to reach a definitive finding.”

Informed consent

Example 2 offers the same scenario, only this time the doctor does not point out his use of AI in his formal report nor has he previously warned the patient. Would this increase the doctor’s responsibility?

The answer to this question, say Harvey and Gowda, raises two more: should the use of AI force the disclosure of the patient, and if so, what should such disclosure entail?

They write that, to date, courts and legislators have not articulated clear rules for informed AI consent. At least for now, it’s not a significant problem, as AI still works largely as a complement to people’s practice of radiology, rather than in the ability to “algorithms that work autonomously. “. If the latter becomes more the norm, informed consent will also increase in importance. At this point, radiologists will need to “be aware of their peers’ disclosures and anticipate the kind of information that patients would find important when deploying AI.”

Collective responsibility

In Example 3, a physician who is worked and supervised by a multispecialty radiology group performs a CT-guided biopsy for spondylodiscitis, a combination of discitis and spondylitis. Although, based on a faulty reading of the AI, the doctor loses the needle during the biopsy, which causes the patient to suffer damage to the adjacent nerve roots. Is the practice group itself at risk of filing a malpractice claim? Most likely, Harvey and Gowda say, assuming the patient can prove he has been injured. If possible, other members of the group may be liable under what is known in civil litigation as “vicarious liability,” whereby a party becomes partially liable for the negligent actions of a third party. In this example, the third party is a consultation employee. The directors of the practice may be held indirectly liable according to the theory that “the faults of subordinates ascend the organizational ladder to join the directors.” For this reason, according to the authors, it is crucial that groups have carefully drafted practice and departmental protocols to use AI-assisted diagnosis.

Medical practices are prohibited; The patient dies

A Florida gynecologist who was found responsible for the death of a woman during childbirth has lost the right to practice medicine, according to a story on, among other news sites.

In July 2017, Onystei Castillo-Lopez went to a hospital in West Palm Beach, Florida, to give birth to her baby. Her surgeon was Berto Lopez, MD, who had been practicing obstetrics and gynecology in the city for nearly four decades.

During labor, Castillo-Lopez began bleeding as a result of what was later said to be “multiple lacerations with a scalpel to the cervix as the baby was born.” A complete hysterectomy is likely to have attenuated the bleeding, but Lopez only performed a partial hysterectomy. Absolutely bloody, he would have left the hospital to change his scrubs. He never returned, however, and Castillo-López died shortly afterwards.

Upon learning of the doctor’s actions, Castillo-Lopez’s family filed a lawsuit.

During the trial, the plaintiffs found that, at the time of Castillo-Lopez’s death, his general practitioner was facing two previous malpractice lawsuits, one of which also involved the death of a patient. . The doctor was under restrictions imposed by the Florida Department of Health. One of these restrictions required that the operation be banned except in the presence of another gynecologist. This limitation of his privileges was apparently known to the hospital, but not to his patients.

Over the years, Lopez had defended himself for several reasons: Castillo-Lopez’s delivery was complicated, surgical lighting was inadequate, his vision was hampered by his deep hemorrhage, and so on.

A court considered each of these arguments but was not convinced. If he found him negligent in the death of Castillo-Lopez. The Florida Board of Medicine agreed and suspended his license after issuing the verdict and sentence.

“He’s a doctor who shouldn’t have been practicing before this happened, and the state knew it and let it go. That’s the lesson to be learned,” said Gary Cohen, a family lawyer with its the Boca Raton.

The content of this article is for informational purposes only and does not constitute legal advice. The confidence in the information provided in this article is made exclusively at your own risk.

Wayne J. Guglielmo, MA, is a freelance journalist based in Mahwah, New Jersey.

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