Patient Suffers Fatal Complications From Endosopic Imaging Study

ByJoseph O'Neill

Updated on

Patient Suffers Fatal Complications From Endosopic Imaging Study

Case Overview

This case involves a male patient who presented to the ER with acute abdominal pain. He was diagnosed with gallstones, however it was noted that there was no evidence of obstruction. The decision was made to take the patient for an ERCP, a medical imaging procedure in which an endoscope is used to introduce contrast medium into the patient’s bile ducts to allow visualization on a subsequent x-ray. The patient was classified as a “high risk” for complications from the procedure, based on his history of obesity, hypertension, and smoking. Nevertheless, he had no cardiac or pulmonary examination or clearance prior to proceeding with the procedure. After undergoing the procedure he was extubated, however he required re-intubation almost immediately, after his breathing was found to be dangerously slow and labored. At this point, he was transferred to the post-anesthesia care unit, where doctors again attempted to extubate the patient. Almost immediately after the patient was extubated, he suffered cardiac arrest. Doctors were unable to successfully revive the patient, and he expired in the PACU.

Questions to the Gastroenterology expert and their responses

Q1

How many ERCPs do you perform per month?

I perform 30-40 ERCPs per month. I perform nearly 360-480 ERCPs annually.

Q2

Are you familiar with the indications for an emergent ERCP?

The only definitive indications for an emergent ERCP are cholangitis or hemobilia and, even in these situations, there are situations where one must consider additional diagnostic evaluation and/or medical management (iv fluid, antibiotics for cholangitis or blood transfusion for hemobilia) prior to ERCP.

Q3

Have you ever had a patient have this complication?

I have published extensively on ERCP and ERCP related complications. I recently published a study on ERCP related duodenal perforations.

About the expert

This highly qualified expert obtained his MD and residency in Internal Medicine from the prestigious Johns Hopkins Hospital. He then went on to complete a fellowship in Gastroenterology at Brigham and Women's Hospital. He also did an advanced fellowship in Gastrointestinal Endoscopy at Johns Hopkins. He is a member of numerous prestigious societies such as the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology. He has published 74+ peer-reviewed articles, case reports, and book chapters in the field of Gastroenterology. He is currently an Assistant Professor of Medicine, the Director of the Pancreatitis Center, and Medical Director of the Pancreatic Islet Autotransplantation Program at a Top 5 Tier University.

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E-035088

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About the author

Joseph O'Neill

Joseph O'Neill

Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.

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