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LEGAL UPDATE
complications in the OR or in PACU, and was discharged from the Bay Shore, N.Y., hospital. The next day, a nurse placing a follow-up
call discovered that Ms. Flanagan was suffering abdominal discomfort. While her discharge instructions had directed her to call the hospital if she noticed increased pain, she had not done so.
After discussing the discomfort, the nurse and the patient agreed that Ms. Flanagan should call the gynecologist who'd performed the surgery about the complication, a decision that the nurse documented in the chart. Ms. Flanagan didn't make the call, though, and after a few days, during which she became increasingly febrile, she presented at the hospital's emergency department with an acute abdomen. An exploratory laparotomy led to a bowel resection with colostomy to repair what was either a delayed colon perforation or a micro-perforation that had progressively enlarged.
Ms. Flanagan and her husband sued the gynecologist for lack of informed consent and negligence in causing the injury. The lawsuit also claimed the hospital and nurse were responsible for aggravating the injury, as they didn't notify the gynecologist of the patient's ongoing abdominal pain.
After a trial in which expert gynecologists testified for both sides, a jury found that the patient gave informed consent and that the gynecologist wasn't negligent in causing the bowel perforation. There was a delay in treatment, however, and while the jury assigned 85% of the responsibility for that delay to the patient, it assigned the other 15% to the nurse. The patient may have agreed to make the call, the jury noted, but the nurse's superior knowledge required her to make certain that the gynecologist was aware of the post-op complication.
Case lessons
