Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Postoperative Bleeding
In June 2000 the Plaintiff’s decedent underwent a Whipple
procedure with pylorus sparing.  At the time of surgery the patient
was 45 years old.  Although not married, he was the father of seven
adult children, all of whom survived at the time of his death.  He had
been living for some 20 years with the mother of 4 of those
children. The elective surgery was begun at 4:30 p.m. by the
Defendant surgeon and Defendant assistant, and he was admitted
to the ICU at 10:30 p.m.  Post operative care was delegated to a
third year surgical resident, who was also a Defendant.  

The operative note indicates the patient had an estimated blood
loss of 3500 cc’s, and received 11,000 cc’s of intravenous fluid and
5 units of packed red blood cells.  Also, 3 Jackson Pratt drains were
placed into the patient’s abdomen.  While in the ICU, continuous
bright red blood was noted in the Jackson Pratt drains on two
separate occasions.  In addition, the ICU notes indicate a significant
drop in blood pressure from 119/83, to 96/69, to 74/54.  The notes
indicate that the Defendant surgical resident was made aware.
Without any written order or physical exam, and even though
morphine had been ordered for pain, the ICU nurse commenced a
Propofol IV drop instead.  Without any written order or the assent of
the resident, the ICU nurse then increased the Propofol from 25
mgs to 50 mgs.  Even though there was a noted drop in the blood
pressure, and fresh frozen plasma and neosynephrine were
commenced, the Propofol was continued. At 2:30 a.m. the blood
pressure increased to 137/107.  However, without a written order or
assent of a physician, or examination by a physician, the ICU nurse
administered a bolus of Propofol.  The patient’s blood pressure
immediately dropped to 41/23.  His heart rate was 120, but he was
without any pulse.  Electromechanical dissociation was noted.  CPR
was started and a code was called.

The Defendant surgical resident assessed the patient and made a
determination of pneumothorax, but never confirmed this by chest x-
ray.  The Defendant surgical resident then inserted a chest tube
into the lower lateral thorax where fluid (not the air that he was
looking for) might be found.  The chest tube returned blood and
was diagnosed to have been wrongly placed through the
diaphragm into the abdominal cavity, which was assessed to be full
of blood.  

The Defendant surgeon returned to the hospital and performed an
exploratory surgery.  He observed “liters of blood” in the abdominal
cavity, and several bleeding vessels were also identified.  Because
the bleeding could not be stopped, the patient was closed and
returned to the surgical ICU.  Unfortunately, the patient died at 2:00
p.m. on the afternoon following surgery, just 16 hours after the first
surgery was completed.The legal action was brought against the
surgeon and his surgical assistant, the third year resident and the
ICU nurse.

The case successfully concluded with a $950,000.00 payment two
months prior to the start of trial.  It is important to note that under
the wrongful death statute and intestacy laws in Massachusetts, all
of the settlement proceeds would be allocated among his seven
surviving adult children, and the woman with whom he was living for
over 20 years and was the mother of four of his children was not
entitled to anything.

Contact Information
If you, your child or a member of your family have been injured as a
result of postoperative bleeding, substandard postoperative care,
deficient medical treatment or failure to be properly treated, please
Dr. Borten and our Boston area medical malpractice attorneys at
Gorovitz & Borten evaluate your case.
For a free confidential consultation and receive a response within
24 hours (when possible), please contact us by phone, fax or e-mail
with your question or concern.

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