That’s the question one of our clients asked a registered nurse when she woke up from a surgery and felt an object on the left side of her abdomen.
“It’s a colostomy bag,” the nurse replied. That sentence must have been one of the worst ones that this woman had ever heard.
“Why’s it there?” the patient continued. The nurse explained that the surgeon encountered some problems during surgery and had to cut out most of her bowels.
A colostomy is the surgical creation of an opening in the large intestine and connecting it to another surgical opening, called a stoma, in the abdominal wall. This diverts the flow of fecal matter from the anus through the abdominal stoma into a colostomy bag.
Instead of handling bowel movements in the private way in the bathroom, fecal matter flows into a colostomy bag that has to be changed.
Sometimes colostomies are necessary because of an underlying health condition, such as cancer, Crohn’s disease, or ulcerative colitis. Other times, they are done because of medical malpractice.
That’s what happened in our client’s case. She went to the hospital for a bariatric surgery to help her maintain a healthy lifestyle and weight. Her surgeon performed a Roux-en-Y gastric bypass. Part of this surgery involves creating connections, or anastomosis sites, between the stomach and intestines.
One of the known risks of having a surgery like this is a potential leak at an anastomosis site. When there is a leak, it’s typically not considered negligence or a violation of the standard of care.
However, it’s an important part of the standard of care for bariatric surgeons and registered nurses providing operating room and post-operative care to be on the look out for signs of problems that could be explained by a leak.
During the first 24 hours after bariatric surgery, our client experienced these abnormal signs and symptoms, all of which should sound alarm bells in the minds of the surgical and nursing staffs:
• Dramatically elevated white blood cell count (WBC)
• High blood pressure (hypertension)
• Rapid pulse (tachycardia)
• Rising sepsis score
While all the signs were there, the nursing staff did make proper notifications to an attending physician, which would have resulted in prompt medical attention. The inexperienced trainee physicians involved in the patient’s care were unable to put together the pieces of the puzzle overnight.
As a result, this patient experienced a significant delay in having her condition diagnosed and treated, which involved a return to the operating room for exploratory surgery. During these many hours of delay, the contents of her bowels were leaking through the anastomosis sites into her abdominal cavity, where they caused a smoldering infection. It wasn’t long until sepsis, a life-threatening systemic inflammatory response to the infection, occurred.
By the time the patient was finally returned to the operating room for life-saving surgery, the infection, swelling, and sepsis had disrupted the blood supply to a significant part of her bowel. This meant that the surgeon had to resect or cut out the necrotic or dead sections.
This significant bowel resection led to the surprising revelation when the patient woke up that she had a colostomy bag. It was only later that she would learn that this embarrassing, foul-smelling colostomy would be a permanent part of her life.
If you’ve been seriously injured because of poor medical or surgical care in Texas, then contact a top-rated, experienced Texas medical malpractice lawyer for a free consultation about your potential case.