Case Summary
This case involves an obese male patient with a past medical history of diabetes. The patient then underwent hernia mesh repair surgery for an incarcerated ventral hernia.
Post-operatively, the patient was then discharged with instructions to follow up in 3-4 months. However, the patient’s surgical site failed to heal well. Later, the patient subsequently presented to the hospital in septic shock. Afterward, the patient died a few months after the hernia mesh repair surgery due to intra-abdominal infection.
Allegedly, the physician was negligent during the hernia mesh repair surgery with the amount of mesh used for the repair. Additionally, the physician was allegedly negligent with the surgical technique.
Case Theory
A known defective surgical device complicates this case. Medical device maker C.R. Bard has a problematic past regarding product safety. Plaintiffs have filed thousands of lawsuits against Bard Medical in part of two massive mass torts in federal court in Ohio and state court in Rhode Island.
Medical errors are a serious public health problem and a leading cause of death in the United States.
Severe complications can happen with an incorrectly performed hernia repair, including bowel perforation. This occurs when the mesh punctures a hole in the bowel or abdominal wall.
In some cases, a perforation can involve other organs. Symptoms often include severe abdominal pain, abdominal rigidity, nausea, and vomiting. An oversized mesh along with a known problematic implant caused the perforation, sepsis, and the unnecessary death of this patient. Additionally, the lack of proper follow-up care also contributed to the causation.
In hernia repairs, surgeons return the organ back to its proper location and then repair the muscle wall. 90% of repairs on average incorporate the use of surgical mesh. Surgical mesh is a material that physicians implant during surgery that provides structural support.
Here, the amount of surgical mesh placed as part of the repair is in question as is the quality of post-operative care.
With this recognized problematic device, caution and extra care, particularly with a known defective surgical device, were not followed. This led to adverse outcomes, including failure of surgical site healing, infection, and death due to sepsis.
Patients may suffer from life-threatening bowel obstructions resulting from adhesions involving a hernia mesh placement. Moreover, hernia mesh complications can lead to fatality.
Expert Witness Questions
- What are the expected clinical implications of improper surgical techniques in incarcerated ventral hernia?
- For incarcerated ventral hernia with mesh repair, what is the standard of care?
- What impact have device recalls and lawsuits done to change the way doctors use this mesh?
- What are the markers of a poor outcome in a post-surgical patient?
- Did the wrong-sized mesh play a part in the poor surgical outcome?
- What is the standard of care for the investigation of post-surgical infection in incarcerated ventral hernia?
Expert Witness Involvement
General Surgeon
General surgeons are skilled in intra-abdominal surgeries of many types. Expert surgeons with special practice in hernia repair and gastroenterology can identify issues of causation and deviations from general surgical standards of care.
Bariatric Surgeon
Bariatric surgeon experts are particularly skilled in surgery involving the abdomen, stomach, and intestine. These expert witnesses are certified bariatric medicine physicians who perform surgical weight loss procedures. These procedures include gastric bypass, gastric sleeve, laparoscopic gastric band, vertical banded gastroplasty, and foregut surgery.
About the author
Erin O'Brien
Erin O'Brien is a senior medico-legal writer and editor, with 25 years of experience authoring healthcare deliverables. Previously, Erin authored an award-winning column in the health and wellness sector, guest hosted a wellness radio show, and received an FMA Charlie Award for Excellence in Writing.
Erin has reviewed and completed case studies for thousands of medical malpractice cases, both plaintiff and defense nationwide, and was presented the US Chamber of Commerce Best Small Business Blue Ribbon designation. Erin is an experienced Medical Risk Consultant and device start-up project manager. She has consulted for numerous successful healthcare and bio-tech start-ups. After completing a Bachelor of Science degree at the University Of Wisconsin, Erin pursued an educational background in Healthcare Risk Management at the University of South Florida. Erin crafts her work with attention to detail, readability, healthcare marketing regulations, and medical standard of care.
