Intrauterine Death of Baby, Injuries Due to Failure to Diagnose Abdominal Hernia
2020 Medical Malpractice Case Report
By Attorney Nicholas D. Cappiello
Woman suffers partial loss of stomach, intestines and unborn baby due to undiagnosed and untreated internal abdominal hernia, receives $2 million medical malpractice settlement
Case summary
Plaintiff suffered the partial loss of her stomach and intestines as well as her unborn baby as a result of an undiagnosed and untreated internal abdominal hernia (twisted bowel loop) causing obstruction and ischemia.
Prior medical history
Her prior medical history included polycystic ovarian syndrome, GERD, chiari malformation, and kidney stones. Her surgical history included cholecystectomy, lap band insertion, lap band removal, and laparoscopic converted to Roux en Y gastric bypass surgery. As a result of her surgical history, the plaintiff was at risk for the development of an abdominal hernia.
High-risk pregnancy
In 2015, the plaintiff was expecting the birth of a baby boy. She was followed throughout her high-risk pregnancy by the defendant obstetrician.
During her pregnancy, the plaintiff experienced recurrent bouts of abdominal pain. In December 2014, she was evaluated with ultrasound imaging, she seen by various specialists, and she was determined to have anemia and malabsorption as a result of her history of gastric bypass surgery. Additionally, she underwent an upper GI endoscopy, which confirmed that her esophagus, GE junction, gastric remnant, Roux-en-Y anastomosis, and small bowel were all normal. The work-up also ruled out a hernia as the cause of her abdominal pain.
Worsening abdominal pain
In January 2015, at 31 weeks gestation, the plaintiff presented to the hospital with complaints of worsening abdominal pain for the past 24 hours, which was worse than past pain during her pregnancy. Her heart rate and white blood cell count were both elevated, although a prenatal ultrasound and a prenatal non-stress test were both normal. The defendant evaluated the plaintiff and noted that the plaintiff was dehydrated with a reactive NST. The defendant administered pain medication, reassured the plaintiff that everything was ok, recommended a walker and pregnancy belt to help with her pain, and instructed her to follow-up four days later.
Intrauterine death of baby
The following day, the plaintiff returned the hospital with ongoing un-relieved abdominal pain. Fetal heart monitoring did not detect a heart rate for the baby and an ultrasound revealed maternal ascites. She was emergently transferred to another hospital where she was taken to surgery. Intra-operatively, the surgeon found an ischemic bowel caused by an internal hernia at the site of her prior gastric bypass surgery, with blow out of her remnant stomach and necrosis of her small bowel and right colon. Additionally, the death of her baby was confirmed.
Injuries result
As a result of the insult to her GI tract, the plaintiff underwent a partial remnant stomach gastrectomy, resection of the JJ anastomosis and small bowel leading up to the ligament of Treitz, and a right colectomy. Post-operatively, she had a prolonged ICU course for septic shock, respiratory failure, pneumonia and renal insufficiency. She eventually recovered and was treated with TPN on an outpatient basis until she could resume solid food.
Lawsuit claims negligence for not ordering further imaging or consult
The plaintiff claimed that the defendant was negligent when she failed to perform abdominal imaging or obtain a surgical consult despite the plaintiff’s severe abdominal pain out of proportion to exam, tachycardia, an elevated WBC, and prior intermittent episodes of abdominal pain concerning for an internal hernia, and when she instead discharged the plaintiff home the night before she lost her baby with reassurance that everything was ok.
The plaintiff further contended that had the defendant rendered proper care, the plaintiff would have undergone further testing, imaging, and surgical intervention in the hospital, the extent of her surgical resection would have been far more limited than what was required the next day, and more likely than her abdominal catastrophe and the intrauterine death of her baby would have been prevented.
The defendant obstetrician maintained that that nothing she did or failed to do caused the injuries to the plaintiff or her baby.
Medical Malpractice Case Settlement
The case was settled for $2,000,000.00.
Lubin & Meyer attorneys Andrew C. Meyer Jr. and Nicholas D. Cappiello represented the plaintiff in this lawsuit.
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