Failure to Recognize Bowel Perforation

Key Takeaways

• Missed Red Flags: Despite severe abdominal pain being a clear indicator of a perforated bowel following a colonoscopy, the medical staff completely ignored the patient’s symptoms.
• Masking the Complication: Rather than investigating the highly unusual pain, the surgical center masked the severe injury with powerful intravenous narcotics (Demerol) and discharged her as the facility was closing.
• Catastrophic Infection: The failure to recognize and treat this known complication allowed a massive abdominal infection (peritonitis) to develop, resulting in a two-month hospitalization, multiple surgeries, and nearly $200,000 in medical bills.

Ignored Bowel Perforation Leads to Life-Threatening Peritonitis

Our client in this case, a retired 70-year-old woman who spent her time providing care to elderly friends and neighbors underwent a routine colonoscopy, and during the procedure she suffered a well-known complication—her bowel wall was perforated by the instrument.

Because perforation is a common known complication of colonoscopy, doctors and nurses should be looking for the specific signs and symptoms of perforation following the procedure, including abdominal pain and abdominal distension (swelling of the belly with air), which causes the belly to feel hard. This case was interesting, in part because there is generally no cause of action when a known complication of a procedure occurs. However, failing to recognize a known complication can be medical malpractice.

Immediately following the procedure, our client relayed significant pain to the doctor and nurses, so she was provided intravenous Demerol, a powerful narcotic pain medication, in the recovery room. The pain was a huge red flag ignored by the doctor and nurses.

Instead of determining why she was in so much pain, which is highly unusual following colonoscopy, powerful narcotics were ordered and administered. The nurses testified that in all their years of experience, they had never seen Demerol given to a patient following a colonoscopy.

Hours later, our client remained in significant pain. She was discharged as the surgical center was closing, and because she was still in pain, the doctor, who did not see her in the hours after the procedure, ordered more narcotic pain medication. Again, the nurses testified they had never seen someone discharged from the center with a prescription for narcotic pain medications.

After several hours at home in excruciating pain, our client asked her daughter to take her to the emergency room, where she was diagnosed with a raging abdominal infection called peritonitis. She spent nearly two months in the hospital battling the infection, and she underwent numerous surgical procedures to help her heal from the infection.

Her total medical bills approached $200,000.00, and the entire episode could have been prevented if the doctor and nurses would have recognized the simple and obvious signs they were trained to spot.