Incisional Hernia

[Saeger]

My mother had surgery in July 2008 for rectal carcinoma tumor removal.  She is 4'11" and, at the time, weighed 188 lbs.  On post surgical day 5, the surgeon's assistant removed the staples from the 9" vertical incision which went from just above the navel to the pubis.  I was there and noted that, as he was starting to removing the staples, the incision was opening.  He said that it was normal for that to happen and not to worry.  When he had 2/3 of the staples out, he stated, "oh-oh, I guess it's too early".  He taped it up and sent her home that day.  Within less than a week, it was gaping open and infected.  It had to be reopened and debrided 3 times before it finally healed about 4 months later.  Her chemo and radiation was delayed until the incision was healed.  

Her cancer is now in remission, however she has a HUGE incisional hernia.  Her surgeon suggested that, in her condition and with the risks of another surgery, it would be best if she did not have repair surgery at this time and suggested wearing a hernia girdle.  

She now weighs 123 lbs, but abdominal measurement is 44".  She is 79 years old.  

Should we be pursuing a malpractice case?  I worked in hospital risk management for 20 years until about 5 years ago.  It seems litigious to me.  Please share your thoughts.

Thank you.

ANSWER: Your mother probably has suffered an injury from medical malpractice. If she pursues a  case, and if she finds a lawyer to help her, she may not have a great chance for compensation. But, the case has enough in it for her to seek a lawyer's help.

Her age is not too much of a factor, depending on her general health priot to surgery. 188 pounds in a woman under five feet tall may be obesity. That is a factor that will be large in any malptractice lawsuit. Incisional hernias are far more common in people who are obese. I mention these items because you do not sound as if you are eager for a lawsuit. And  malpractice lawsuits are not for pleasure.

However, the infection and the rush for the doctor to send her home is evidence of malpractice. She should have been kept in the hospital for at least a full day so her wound could be observed. The infection probably resulted from tbe staple removal at her bed. She should have been moved to a sterile dressing room for this procedure. The doctor should have scrubbed, although the hospital may not have strict regulations for after care. If it does not, then the hospital needs to be named in the suit. Having a open hernia(is it? You make it slound as if the wound has not healed) is hardly something to be cared for at home without some provision for nursing care by the hospital.

Your mother does have a serious injury. She should be compensated as well as assured that the hospital and the doctor(although she should choose an infectious disease doctor to supervise her care) should see her on a close to daily schedule until she has her surgery for repair of the hernia. She is at higher risk because of delay in attacking her cancer. She has a lot to be compendsated for, and if no one, the doctor or from the hospital, has come up with an offer to help, then she must see a lawyer. And a good one. Your local Bar Association may provide a list of qualified lawyers to help. Choose one carefully. He must have the money for the case and the will to fight.

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

Yes, prior to her surgery, she was obese, and had many heart problems.  

No, the hernia is not open now.  The surgery was in 7/08, wound finally healed in 11/08.  After her chemo and radiation, she had her ileostomy(which was placed during 7/08 surgery) taken down in 4/09.  She has not had an infection since 11/08.  Her surgeon is saying that she really is too weak and there are too many possible complications to perform the hernia repair at this time(and maybe never). Basically, he is saying that she will need to live with this giant hernia forever.  

You are correct, I am not eager for a lawsuit unless it's a "slam-dunk".  After working the defense side of risk management for 20 years, I am fully aware of how difficult lawsuits can sometimes be, unless they are very cut and dry, in which case they most often end in a settlement rather than going all the way to court.  I guess that's my bottom-line question.  Is this a slam dunk?  Or will the defense say the incisional hernia is a "normal complication" in an obese woman?  

Thanks so much for taking the time to consider my questions.

[Romeo]

Your mother's case is NOT a slam dunk. It has several problems, age, obesity, and the cancer. Juries are reluctant to give money to someone who they think is dying anyway, and cancer sounds like a death warrant to most people. You should follow your instincts here. Malpractice lawsuits are a tough deal for most people, and your mother may not enjoy any of it.

Unfortunately most medical malpractice cases are NOT won by the injured patient. Just listen to those Senators on the air today. The most they can say about Obama's 'health care' plans is that they want to limit malpractice costs for doctors and hospitals. Never a thought for the injured patient. Cost for a quadriplegic whose injury resulted from a 'spinal' is about 10,000 bucks a month. How can you 'limit' that? The biggest problem with medical malpractice is that so much of it happens. It is the SECOND cause of death in this country, after stroke and heart attack. That is according to the findings of the CDC.

I am sorry about your mother. I am even more sorry about medical malpractice and the idiots who can think only of reducing the 'cost'. We need to reduce the number of injured and killed patients every year. That is what we need to do.

An idiot doctor, an orthopedist named Jeff, continues to try to stop me from answering questions on this web site. He could do far more good by attacking those doctors who have more than two malpractice lawsuits filed against them. Any doctor who has three lawsuits for malpractice should be stripped of his license. You will find that most of the doctors in that group use drugs, drink before working, have lousy personal lives and care zilch for their patients. I know because I have talked to so many of them. Those doctors terrify me.

But, good luck.