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Medical Malpractice - Nearly Lethal Surgery On Prednisone User

Been the victim of Medical Malpractice or fighting a malpractice suit? Discuss it here.

Medical Malpractice - Nearly Lethal Surgery On Prednisone User

Postby Ordsone » Fri Nov 25, 2016 9:27 am

Prior to an exceptionally complex elective bariatric bypass surgery in September 2007, my wife had been taking high dosage of Prednisone for more than two years.  She has suffered greatly and nearly died because of persistent leaks in the many re-connections of her entire digestive system in that procedure.  After four months in the hospital, her struggle still continues a year later.

Retarded healing from Prednisone use and “leaks” are known risks of this kind of surgery.  However in this case, the leaks were pervasive, severe, ongoing and a virtual certainty because of the “thin skin” side effect often found in long term users of high dosage of Prednisone.  This greatly added risk was not known by us and it was never mentioned.  We now know that this elective procedure should have been postponed until she had been appropriately weaned off the Prednisone which we now understand to be the recommended pre-surgery practice when possible - as it certainly was in this case.

In a post operation conversation with the surgeon, I clearly remember the puzzled look on his face as he lamented about the mystifying repeated failure of his sutures during the procedure.  He compared his ordeal to attempting to sew tissue paper.  He went on to tell me about lathering on copious amounts of surgical adhesive and using her body fat as patches to try to close the numerous leaking sutured areas.

Of interest is the “Operative Report” currently in the hospital file.  It is noted as a “re-dictated” report to replace the “lost” original report.  It completely refutes what he said to me in that conversation.  Added to its noteworthiness is that in a typically cryptic document, he twice mentions the good condition of my wife’s tissue.  I believe he realized his error after our conversation and then re-wrote history.

Suture failure lead to other problems including failure of her “J tube” - the feeding tube inserted in her intestines to provide adequate nutrition during her recovery.  They gave up after several trips to the OR to reinsert it.  The IV was her only nutritional intake for her four months in the hospital.

A plastic surgeon recently confirmed informally that the “thin skin” side effect of Prednisone applies to deep tissue and organs as well.

My wife is still very ill and faces an eight inch long abdominal hernia repair next month … this left over from the original surgery in September, 2007.

Do we have a case ?

ANSWER: You have apparently done extensive research on your own, and from what you have written here, I'd say you probably knew more about patients on chronic steroid use than that surgeon. Let me guess that he is about fifty five years of age. Prednisone use over long periods was acceptable during the  1970s-80s and this surgeon probably did not even think about your wife's over use. Also, maybe he had never spoken to her physician prior to surgery about prednisone. Today a surgeon would know better, but as you see, some are left over.

Do you have a case? Maybe.You don't say why your wife had all this surgery, but chronic obesity is probably the basis. Obese patients are difficult and often have poor surgical results, but this doctor apparently told you he could do this surgery. On that basis, and on the basis of what you have said here, I'd say you have a case, dependiing.

You will have to find a lawyer who has had some experience in this kind of case. He will have to try to find the original operatiove report, and in today's atmosphere of concealment among doctors and hospitals , he will face a stiff challenge. So, he is going to have to be crafty and rich to carry your case. In the past five or more years a new law called HIPAA was passed. It is the Health Insurance Portability and Accounting Act. This was to provide a way for employees on the move to bring their health insurance along with them to a new job. But our beloved insurance industry managed to get Accountability into the act, and for therm acountability meant to conceal from anyone other than a spouse anything about the patient and her care.

Don't let me discourage your from sueing. Sue the bastards. Especially because you know they will be lying. You must at least make a records of their concealment. And who knows, you may win this one. Changing medical records is one sure way for doctors to lose their case.

---------- FOLLOW-UP ----------

Many thanks for the quick response.  Your input is greatly appreciated.

The Prednisone was appropriately prescribed for a long standing problem my wife had, and it was thoroughly disclosed to the surgeon and the hospital.  Her GP and Rheumatologist(and Cardiologist) signed off on the procedure.

The surgery was elective as an appropriate effort to treat her diabetes and sleep apnea.  Had it been delayed to wean her off the Prednisone as we subsequently learned to be appropriate, there would be no issue.

I believe the real issue here is whether the surgeon did - or should have known that the "thin skin" side effect of her long term use of Prednisone was likely to result in suture failure in a complex surgical procedure.  I believe he did not know.  This belief is based on the post surgery conversation I recited.  But, I strongly believe he should have known.

Almost all medical professionals are aware of the retarded healing, the ”thin skin” and other common side effects of Prednisone.  But I don't feel it was the responsibility of her GP or her Rheumatologist to be knowledgeable about translating that well known “thin skin” side effect to specific issues(suture tearing) in surgical procedures.  But the surgeon certainly should have been aware of this concern.

My dilemma is that as a layman, I have not been able to confirm that he should have known.

As you know, medical professionals are not willing to step into a potential litigation against another.  Finding evidence on my own has proven fruitless.  I've contacted the FDA who wanted to receive a report of the incident, but was not helpful otherwise.  I used the research facilities of the U.S. National Library of Medicine(NLM).  They gave me scores of possible references to look at.   Unfortunately, most of those references were unavailable to me as a non-professional.  Those I was able to have access to were not meaningful to me for the same reason.

We live in a small isolated community with very limited medical resources.  A difficult  follow-up hernia repair is scheduled in just weeks(she is off the Prednisone).  If we start seriously seeking local support for this potential litigation, medical help for her may become unavailable … and that is not unrealistic.

Incidentally, we have all of the surgeon’s and the hospital’s files including the “re-dictated” version of the “lost “OPERATIONAL REPORT”.  Obviously, we don’t - and won’t have access to that “lost” original report.

Again, thanks for your input.  Might you have any suggestions in light of my response ??

Best regards,

Hugh
Ordsone
 
Posts: 49
Joined: Sat Feb 15, 2014 8:34 am

Medical Malpractice - Nearly Lethal Surgery On Prednisone User

Postby Prescot » Fri Nov 25, 2016 5:37 pm

Prior to an exceptionally complex elective bariatric bypass surgery in September 2007, my wife had been taking high dosage of Prednisone for more than two years.  She has suffered greatly and nearly died because of persistent leaks in the many re-connections of her entire digestive system in that procedure.  After four months in the hospital, her struggle still continues a year later.

Retarded healing from Prednisone use and “leaks” are known risks of this kind of surgery.  However in this case, the leaks were pervasive, severe, ongoing and a virtual certainty because of the “thin skin” side effect often found in long term users of high dosage of Prednisone.  This greatly added risk was not known by us and it was never mentioned.  We now know that this elective procedure should have been postponed until she had been appropriately weaned off the Prednisone which we now understand to be the recommended pre-surgery practice when possible - as it certainly was in this case.

In a post operation conversation with the surgeon, I clearly remember the puzzled look on his face as he lamented about the mystifying repeated failure of his sutures during the procedure.  He compared his ordeal to attempting to sew tissue paper.  He went on to tell me about lathering on copious amounts of surgical adhesive and using her body fat as patches to try to close the numerous leaking sutured areas.

Of interest is the “Operative Report” currently in the hospital file.  It is noted as a “re-dictated” report to replace the “lost” original report.  It completely refutes what he said to me in that conversation.  Added to its noteworthiness is that in a typically cryptic document, he twice mentions the good condition of my wife’s tissue.  I believe he realized his error after our conversation and then re-wrote history.

Suture failure lead to other problems including failure of her “J tube” - the feeding tube inserted in her intestines to provide adequate nutrition during her recovery.  They gave up after several trips to the OR to reinsert it.  The IV was her only nutritional intake for her four months in the hospital.

A plastic surgeon recently confirmed informally that the “thin skin” side effect of Prednisone applies to deep tissue and organs as well.

My wife is still very ill and faces an eight inch long abdominal hernia repair next month … this left over from the original surgery in September, 2007.

Do we have a case ?

ANSWER: You have apparently done extensive research on your own, and from what you have written here, I'd say you probably knew more about patients on chronic steroid use than that surgeon. Let me guess that he is about fifty five years of age. Prednisone use over long periods was acceptable during the  1970s-80s and this surgeon probably did not even think about your wife's over use. Also, maybe he had never spoken to her physician prior to surgery about prednisone. Today a surgeon would know better, but as you see, some are left over.

Do you have a case? Maybe.You don't say why your wife had all this surgery, but chronic obesity is probably the basis. Obese patients are difficult and often have poor surgical results, but this doctor apparently told you he could do this surgery. On that basis, and on the basis of what you have said here, I'd say you have a case, dependiing.

You will have to find a lawyer who has had some experience in this kind of case. He will have to try to find the original operatiove report, and in today's atmosphere of concealment among doctors and hospitals , he will face a stiff challenge. So, he is going to have to be crafty and rich to carry your case. In the past five or more years a new law called HIPAA was passed. It is the Health Insurance Portability and Accounting Act. This was to provide a way for employees on the move to bring their health insurance along with them to a new job. But our beloved insurance industry managed to get Accountability into the act, and for therm acountability meant to conceal from anyone other than a spouse anything about the patient and her care.

Don't let me discourage your from sueing. Sue the bastards. Especially because you know they will be lying. You must at least make a records of their concealment. And who knows, you may win this one. Changing medical records is one sure way for doctors to lose their case.

---------- FOLLOW-UP ----------

Many thanks for the quick response.  Your input is greatly appreciated.

The Prednisone was appropriately prescribed for a long standing problem my wife had, and it was thoroughly disclosed to the surgeon and the hospital.  Her GP and Rheumatologist(and Cardiologist) signed off on the procedure.

The surgery was elective as an appropriate effort to treat her diabetes and sleep apnea.  Had it been delayed to wean her off the Prednisone as we subsequently learned to be appropriate, there would be no issue.

I believe the real issue here is whether the surgeon did - or should have known that the "thin skin" side effect of her long term use of Prednisone was likely to result in suture failure in a complex surgical procedure.  I believe he did not know.  This belief is based on the post surgery conversation I recited.  But, I strongly believe he should have known.

Almost all medical professionals are aware of the retarded healing, the ”thin skin” and other common side effects of Prednisone.  But I don't feel it was the responsibility of her GP or her Rheumatologist to be knowledgeable about translating that well known “thin skin” side effect to specific issues(suture tearing) in surgical procedures.  But the surgeon certainly should have been aware of this concern.

My dilemma is that as a layman, I have not been able to confirm that he should have known.

As you know, medical professionals are not willing to step into a potential litigation against another.  Finding evidence on my own has proven fruitless.  I've contacted the FDA who wanted to receive a report of the incident, but was not helpful otherwise.  I used the research facilities of the U.S. National Library of Medicine(NLM).  They gave me scores of possible references to look at.   Unfortunately, most of those references were unavailable to me as a non-professional.  Those I was able to have access to were not meaningful to me for the same reason.

We live in a small isolated community with very limited medical resources.  A difficult  follow-up hernia repair is scheduled in just weeks(she is off the Prednisone).  If we start seriously seeking local support for this potential litigation, medical help for her may become unavailable … and that is not unrealistic.

Incidentally, we have all of the surgeon’s and the hospital’s files including the “re-dictated” version of the “lost “OPERATIONAL REPORT”.  Obviously, we don’t - and won’t have access to that “lost” original report.

Again, thanks for your input.  Might you have any suggestions in light of my response ??

Best regards,

Hugh
Prescot
 
Posts: 46
Joined: Wed Jan 01, 2014 11:49 pm

Medical Malpractice - Nearly Lethal Surgery On Prednisone User

Postby Jagger » Sat Nov 26, 2016 3:54 pm

Your research is impressive. Your using the NIH Library shows that you have done more realistic research than most doctors and or lawyers. Good work.

I suggest you run your case by at least two or three malpractice lawyers in the largest city in your state. You can assure them that your help will be valuable, and maybe you can line one up. The 'lost' report may never be found, but medical records have a way of referring to lost reports, for instance the reportt of supplies from Central Supply for the 'lost' surgery will list a lot of stuff that may not be mentioned in the 'final' report. Play with the records and see what they show you. By the way, make several copies of what you have, and save one that is not  marked. You will need to give reports to lawyers, so make enough copies.

Good luck.
Jagger
 
Posts: 58
Joined: Tue Dec 31, 2013 5:53 pm


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