Severe Abdominal Pain Leads to Fatal Outcome Due to Delayed Intervention

Case Overview

This case involves an elderly individual who underwent ulcer excision and repair. Following the surgical procedure, the patient began experiencing severe abdominal pain. Allegations have arisen that the nursing staff on duty failed to notify the attending physicians of the patient’s escalating pain and instead opted to administer substantial doses of opioids to manage the discomfort. This decision resulted in a lack of appropriate diagnostic workup for the source of the abdominal pain. Tragically, within a few hours, the patient progressed to septic shock, leading to cardiac arrest and ultimately resulting in death. The focus of this case is to assess whether the nursing actions met the standard of care expected in post-operative settings.

Questions to the Nursing expert and their responses

How does the timeliness of intervention typically affect patient outcomes in cases of severe abdominal pain?

Timeliness is incredibly important when it comes to abdominal surgery patients. Patients can get their bowels nicked or suffer surgical complications that can quickly become life-threatening if not escalated to the physician/chain of command.

What are the most pertinent signs and symptoms in patients who have undergone GI surgery that should be relayed to a treating physician?

Abdominal pain, tenderness and swelling to the area, tachycardia, hypotension, fever, chills, and elevated white blood cells are all signs and symptoms in patients who have undergone GI surgery that should be relayed to a treating physician.

About the expert

This expert has over a decade of experience in the field of nursing, specializing in medical-surgical, telemetry, and surgical nursing. He earned his BSN from the University of Texas Health Science Center School of Nursing and his MSN from Walden University. Today, he is a licensed registered nurse in the state of Texas. Previously, he served as a telemetry staff nurse, as a telemetry charge nurse, and as an interim telemetry supervisor at Christus Health. In addition, he served as a telemetry charge nurse and as the director of telemetry nursing at Methodist Texan Hospital. Currently, this expert serves as the director of nursing for a health system in Texas.

E-388453

Specialties:

Nursing

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.