General Surgery Experts Opine on Intestinal Infection Caused by Negligent Suture Placement

This case involves a woman who underwent routine intestinal surgery to repair a hernia at her local hospital, which utilized a Composix mesh product. The procedure was unremarkable for any complications, and the patient was discharged after a brief recovery period. Over the next several weeks, the patient complained of severe, persistent pain, however her complaints were ignored. Eventually, the patient presented to the ER, where she underwent emergency surgery for a suspected diagnosis of sepsis. It was discovered that the original operating physician had applied sutures that had pierced the intestinal wall, allowing bacteria to migrate from the intestine into the abdominal cavity.

Question(s) For Expert Witness

1. Do you routinely treat patients like the one described in this case?

2. Have you ever had a patient develop this outcomes?

3. Based on the summary of the case do you believe that the patient might have had a better outcome had the care rendered been different?

Expert Witness Response E-008637

I do treat patients with complex abdominal hernias like the ones described in this case. While recurrence of incisional hernias may happen and sometimes cannot be prevented, complications such as this from incorporating the bowel into the abdominal wall closure should not happen with careful surgical technique. Luckily, I did not have a similar outcome in any of my patients. I do believe the patient's outcome might have been better if the care rendered was different: (1) at the time of the original closure, if the bowel wall was not incorporated into the sutures - there are many ways to prevent this; (2) in the immediate postoperative period, when the patient did not feel right and was dismissed by her surgeon, further investigation might have identified the complication early.