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Balanay v. Vance Knoll, M.D., Oscar Andres, M.D. and Mercy-Methodist Hospital

Dr. Fagel and his associates achieved a verdict of $883,081 on behalf of the surviving husband and three children of a 46-year-old woman who died of infection following an abdominal hysterectomy. Failure to examine the patient prior to discharge and provide prophylactic antibiotics led to severe infection, which ultimately resulted in Acute Respiratory Distress Syndrome, organ failure and death. In addition, failure to immediately perform surgery to remove the infection lessened the patient’s chances to properly recover.

The plaintiff was initially discharged 3 days after the hysterectomy, without examination by her gynecologist after he was told she was afebrile and feeling fine at the time of release. The deposition of the hospital nurse revealed that she noted high temperatures (up to 100.6 degrees) in the patient prior to her discharge but did not notify the gynecologist. The nurse prescribed pain medication prior to the plaintiff’s release, but the patient began experiencing pain the next day. Despite taking higher doses of pain medication, as ordered by the defendant’s nurse practitioner, the patient’s pain escalated over the next two days and she eventually had to be taken to the emergency room. The patient’s physician examined her and elected to admit her to the ICU for observation rather than perform surgery right away. The next morning, the physician took the patient into surgery after her condition had worsened. A large amount of infected fluid was removed, but the patient never fully recovered and died from complications four weeks later.

The defendant gynecologist claimed that prophylactic antibiotics were not needed for routine hysterectomy surgery and that he was not negligent for discharging the patient based on the information provided by the hospital nurse. The defendant physician contended that surgery was not indicated because there was no surgically correctable problem when the patient was first admitted to the emergency room. Finally, the defendant hospital claimed that the patient’s condition prior to her initial discharge did not require retention because she did not have a high temperature at the time of her release and her temperature was never above 101 degrees. The verdict was reached after 12 days of trial and one day of deliberation. The verdict labeled Comparative Liability of 50% for the gynecologist, 30% for the hospital and 20% for the physician.