Doctors Needlessly Delay Treatment of Septic Shock Following Colectomy

Case Overview

This case involves a male patient who underwent a colectomy to treat diverticular disease, and was discharged home on postoperative day 3. The patient was discharged with medications for pain and instructions to call the emergency room if a fever developed. While home, the patient began to complain of severe abdominal pain. Later that day, the patient developed a temperature of 101. The emergency room was called and informed of the fever, however the patient was instructed to take Tylenol and visit the doctor’s office in the morning. The patient was brought to his office, where the patient reported that he was still having abdominal pain, which the defendant attributed to the surgery. He increased his prescription for painkillers and discharged the patient with a follow-up scheduled a week later. The patient continued to experience abdominal pain, and did not urinate at all upon his return home. Eventually, the patient presented to the emergency room, where the emergency room doctor noted that the patient had a distended abdomen with decreased bowel sounds and tenderness in the lower right quadrant. IV fluids were started, a foley catheter was inserted, labs were ordered, antibiotics were given and a CT scan was ordered by the emergency room doctor. The results of the CT scan were significant for an anastomotic leak, and the defendant physician gave telephone orders to admit the patient to the Intensive Care Unit. The patient was not operated on for several hours, as doctors awaited the results of a second set of imaging studies. Eventually, the patient underwent emergency surgery to repair the bowel leak, which initially appeared to have been performed successfully. However, over the next few hours the patient’s condition continued to deteriorate rapidly. After a number of subsequent surgical interventions were unsuccessful, the patient was declared dead from septic shock secondary to ischemic bowel.