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Could this be considered Malpractice??

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taddles

Junior Member
What is the name of your state (only U.S. law)? PA

I will try and be breif but also try and give enought facts.
I suffer from Crohns Disease. In January of 09 I went to a well know very large University teaching hospital for a bowel resection ( my second in 13 years)
my resection was on a monday. i was to be there at roughly 10:30am but was not taken back til about 4pm that day and surgery was finished successfully around 8pm.

i was recovering, as i was told, well and incision site was doing fine. one night however i was in terrible pain one evening and awake all night ( on their 0-10 pain scale i was well over 10) i was on a pain pump and also had epidural to no avail. i had the nurse page resident on call to no avail, she paged her numerous times but she never came. per my patient bill of rights, isnt the hospital required to be sure paitent is receiving adequet pain management? this, in my opinion was the begining of the disaster i ended up suffering while there but this is not the most important issue at hand.

i had a CT scan maybe 3 days after surgery and was told they were seeing "air" around the site of resection. maybe a day or two after that, the surgeon came to my bedside and said he had to open my incision since one of his residents told him there was feces coming from my incision site. but there were always positive appraisals by nuring staff of how i was healing. so basically, the doc sat on the side of my bed, asked a nurse for a pair of gloves and a scalpel. while in his suit and not covering him self with a gown or me for that matter. they gave no local pain medication, did not swab and culture the incision to see if discharge was normal (this was not an emergent procedure), never obtained an informed consent from me. i was alone in the room medicated fairly high on pain meds, did not ask if i wanted to contact a family memeber for an objective opinion from them, proceded to open my incision with a fairly large opening.

i was not allowed to eat since they thought my intestines were leaking which no Ct scan revealed. i was put on a pic line (to which i signed consent) and they were also going to put a drain out the right side of my body and consent was also then given. but when the interventional radiologist scanned me prior to placing drain, he stated he was not putting one in as based on previous 2 ct scans and then his, there was no leak to drain.

eventually after 12 days in the hospital i was discharged with the open wound to be packed for 19 weeks before it finally closed. his office was giving me a prescription for percocets every two weeks until july. i was on the PIC line for a month. after the wound closed in the end of may, i was found to have and enormously large hernia from the abdominal wall hanging open for so long. this was diagnosed when i went for a consult of possible scar revison as my belly button was off center and the open wound healed looking like a second belly button. the PA for the surgeon had given me prescriptions for percocet up until July when i had my first consult with the plastic surgeon.

i had my hernia repair in october of 09, at a different hospital by the chief of plastics. i even asked him, had i not had the open wound, would the hernia have occured. he said prob not.

i requested my chart for review from the hospital for the bowel resection. on the date the doctor opened my incision there is a 3-4 sentence hand written statement that is unreadable with a little diagram drawn to show what he did. to this day i am still wearing a fentenyl pain patch.

i may be missing some necessary history, but would any of thie indicate misdiagnosis ( by not doing a culture on drainage first and not obtaining consent and then opening my abdomen in my room in a very non-sterile environment)
 
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lealea1005

Senior Member
i may be missing some necessary history, but would any of thie indicate misdiagnosis ( by not doing a culture on drainage first and not obtaining consent and then opening my abdomen in my room in a very non-sterile environment)
There was no need to culture the drainage given the abnormal results of the CT scan. A sterile envirnoment was not necessary. Although I might have put on a paper gown to protect my clothing, a gown was not required, AND your Physician did wear gloves to protect himself from your drainage.

The Physician took your sutures out and, in fact, did not make a new incision into your abdomen, correct? There was no need for swabbing or anesthesia of any kind.

It was necessary for the wound to close via granulation (from the bottom up). It is a long process that requires frequent packing of the wound and your picc line allowed for antibiotics, or other medications, to be given during the healing process.

Although the Plastics Surgeon was correct regarding the hernia, the fact remains that without the suture line being opened and drained, the outcome could have been much worse.

The possibility of infection, and the procedures to correct or treat it was, most likely, covered in your informed consent. None of us are privvy to it's specifics.
 
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taddles

Junior Member
so basically they do not have to get my consent to do anything additional after the surgery? that does not seem right. shouldn't a patient have the informed choice to say whether they would like to proceed immediatly with this, get a second opinion or perhaps just simply discussing with a family member to be sure it is the right thing to do?? the incision he made in the existing surgery site was very large. and just becasue he was only removing sutures, trust me, does not mean i did not feel great pain when he did it.
not that it matters at this point i suppose but my PIC was only used for feeding, since they cut me off from anything by mouth for one month
 

lealea1005

Senior Member
so basically they do not have to get my consent to do anything additional after the surgery? that does not seem right. shouldn't a patient have the informed choice to say whether they would like to proceed immediatly with this, get a second opinion or perhaps just simply discussing with a family member to be sure it is the right thing to do?? the incision he made in the existing surgery site was very large. and just becasue he was only removing sutures, trust me, does not mean i did not feel great pain when he did it.
not that it matters at this point i suppose but my PIC was only used for feeding, since they cut me off from anything by mouth for one month
Depending upon the wording of your informed consent, it may have been included as part of the surgical time period.

I did not infer that you were not in pain while your suture line was being opened. I'm sure it wasn't pleasant. It was imperative to open and drain your incision site asap. There may not have been time for a second opinion or the advice of a family member without medical knowledge. Waiting could have compromised your condition quickly.
 

taddles

Junior Member
i do not know exactly how imperative it was considering the doctor did not understand why i had no fever or abnormal lab work. then it started to be referred to as a "wound infection" i did not have a wound infection. the hospital even sent a letter to the fact thatt they were aware of my supposed wound infection.

after obtaining my chart all the CT scans states "air" or "gas" only. i do not consider that an abnormal CT scan which justifies opening a patient beside based on the surgeons resident who "thought" there was feces. and yes, i was told by the surgeon, he was opening the surgical site based on the resident thinking this.
in my personal experience with dealing with this for 25 years. air and gas in the abdomen is normal after a surgical procedure where the abdomen has been opened.
the only option i really have is to have my chart review by a mal prac attorney and go from there. half of the chart is illegable with i think is a disgrace on its own considering this is a teaching hospital and how can it be acceptable for the doc to perform this bedside procedure and then not even take the responsibility to write in a fashion in which his notes can be read, especially in this world of EMR (electronic medical records) in this day and age hand written charts that cannot be read, a doctor especially one responsible for teaching the next generation of surgeons, should be held accountable for any and all dictation that can be interpretted many ways due to the handwriting
 

lya

Senior Member
Air and gas around an internal surgical site is indicative of infection.

I see no malpractice or negligence in the scenario presented.

Chrons Disease is an inflammatory and auto-immune process and complicates all aspects of medical treatment. Healing is impaired or at high risk of being impaired. Pain management is difficult as such conditions often cause rebound pain from narcotics.

All handwriting, including that of MDs, is required to be legible. Unless you received damaging treatment or damaging lack of treatment due to illegible handwriting's causing the act of negligence, it is noncontributory in your scenario.

For your peace of mind, have your records reviewed by a medmal attorney. Consultations for medmal are usually free.
 

taddles

Junior Member
yes that is the plan, to have it reviewed and go from there. especially since i continue using a pain patch and it has been 15 months now since the first suregery. i cannot continue to use pain meds ( and i have a pretty high tolerance for pain as do alot of crohns patients thinking this is jsut the life they will have to lead) it is no way to lead a productive life style.
thank you all for your comments and support, if for nothing else, to be sure no other patient would have to endure what i did. i also plan on donating my body to science when i pass ( hopefully a loooong time from not ) if it would help the doctors learn even just one thing for future suffers
 

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