Treatment and Costs of Burn Injuries

In May 2016 the firm confidentially settled a medical malpractice action for 97.5% of the physician’s available coverage.

The case involved a surgeons care and treatment of a small rectal carcinoid tumor approximately 9-10 cm from the anal verge which had been discovered during a routine screening colonoscopy for a 50 year-old African –American woman. The colonoscopist had biopsied the growth and the pathology report established that this was a 5mm rectal carcinoid with no dangerous or aggressive characteristics.

The medical literature established that a neuro-endocrine tumor of this nature and size with these characteristics should be examined preoperatively with an endo-rectal ultrasound to determine whether there had been any penetration beyond the submucosal layer or any spread into adjacent lymph nodes. In the absence of such pre-operative findings the literature established that simple excision local through an intra-anal procedure was the appropriate treatment.

Rather than proceeding in compliance with the well-established literature and discussing various alternatives with his patient, the surgeon advised the client that she had to have a low anterior resection.  The patient developed a problem with fecal urgency shortly after the surgery.  When she did not feel she was getting enough or adequate help with this problem she switched surgeons to get a second opinion. Her new surgeon found that she had developed a stricture only slightly above her rectum. After efforts to stretch the stricture failed the surgeon undertook an exploratory procedure to identify the underlying cause of the problem. The surgeon discovered that a leak had developed at the site of the first surgeon’s reconnection of the two ends of the intestine. The leak created extensive scar tissue which strictured around the bowel and impaired the patient’s ability to control her bowel movements. This stricture produced an almost constant number of small bowel movements each of which had a very loose or pudding-like consistency. The patient had to be in the bathroom almost every half hour to have a bowel movement. The new surgeon discovered that the leak had caused so much scar tissue that despite having adequate length of large bowel to attempt a reconnection, there was no viable opportunity to redo the connection because the adjacent scar tissue would prevent a long term recovery. The new surgeon had no choice but to create an ostomy bag for the patient.

Examination of the initially removed section by the pathologist had confirmed that the original tumor had not become invasive and no lymph nodes were involved. Our experts concluded that the original surgeon had violated the standard of care by proceeding with a low anterior resection instead of a local trans-anal excision. They noted that radical resection and reconnection in the rectal/anal area runs a recognized risk of multiple complications including a leak at the site of reconnection. That risk was unnecessary. One of our experts put it very succinctly when he  noted that using major surgery on this tumor was like curing an in-grown toenail by performing a below the knee amputation. It got the job done but was totally inappropriate and dramatically beyond what needed to be done.

On April 22, 2016, we obtained a verdict in the total amount of $875,000.00 for our clients in a case in the State Court of DeKalb County.

Our plaintiff had gone in for a routine Lasik procedure but there was an error during the surgical process. The ophthalmic surgeon failed to recognize that the prescription had been improperly input into the computer. The error was that the computer was told that the correct axis for treatment was 180 degrees rather than 80 degrees. Accordingly, the computer’s ablation pattern was on a horizontal track rather than the correct pattern which would have been almost vertical. Instead of removing the patient’s astigmatism, this error caused a doubling of her astigmatism.

The problems created by this error were compounded when her surgeon and her optometrist recommended that she undergo an immediate procedure the next day to try and correct the mistake. Plaintiff contended that she was not told in advance of this procedure that there had been a physician error during the initial procedure, but was only told she was having a normal reaction to Lasik surgery and she simply needed a small “trim” to resolve her problems. She testified that if she had been told there had been a physician error she would not have proceeded as she did but would have sought out a second opinion from another ophthalmic surgeon before allowing any further procedures. There was testimony that the standard of care requires allowing the eye to “settle” for a period of 4-6 months before any effort at retreatment occurs because it is impossible to determine what the “settled” shape of the eye is going to be after an initial Lasik procedure.

We contended this was not a minor “trim” but instead was a major effort at covering up the original physician error. Our experts established that this next-day surgery, which in fact had involved almost 4 times the ablation used in the initial procedure, caused permanent and uncorrectable injury because it caused irregular astigmatism which cannot be effectively treated. We established that as a result of her irregular astigmatism she had very serious problems with glare, bright lights, fluorescent lights, and bright sunshine and problems working with video screens. Since she was a comptroller her job required heavy computer use and she simply could not find a way to maintain her job performance given the limitations imposed on her by this results of her surgery.

After 2 hours of deliberation the jury returned a verdict in the total amount of $875,000.00.

Our client was a 58 year old undergoing dialysis 3 times a week at a company facility. The evidence showed that on this particular occasion immediately prior to treatment the patient had a blood pressure of 174/66 with a pulse of 86 and that 5 minutes later after dialysis had been begun she had blood pressure of 108/35 with a pulse of 102. Despite recording these values only 5 minutes apart the technician in charge of this patient did not stop the treatment or call for nursing intervention. The patient was found 5 minutes later in full cardiac arrest and was not able to be resuscitated.

Our nursing experts was able to establish that it was a departure from the standard of care for the technician to have proceeded with dialysis I under these circumstances. The death was clearly produced by the failure to intervene in timely fashion. The company agreed to a confidential mid six figure settlement.