patients unusual anatomy no excuse for medical malpractice

During surgery two years ago to remove a woman’s gallbladder, a surgeon cut the woman’s hepatic duct by mistake. The patient suffered unnecessary pain from the cutting, and had to have additional surgery to correct it. Now she has been awarded $250,000 in damages by a California court after suing the board-certified surgeon for medical malpractice.

The hepatic duct drains bile from the liver, and joins with the cystic duct, which comes from the gallbladder. The surgeon in this case meant to cut the cystic duct (which would not be needed without a gallbladder) in order to remove the gallbladder. Instead he cut the hepatic duct (which the patient was going to need).

The patient was forty-two years old when she went to the emergency room in June of 2008 complaining of severe abdominal pain. She was found to have a large gallstone and a thickened gallbladder. The surgeon performed laparoscopic surgery the next day to remove the gallbladder. The laparoscopic method is usually minimally invasive. The doctor uses a video camera to identify internal organs, and uses slender surgical instruments.

In court documents, the woman claimed that the surgeon misidentified the hepatic duct as the cystic duct and cut the wrong one.

Interestingly, the surgeon did not disagree. He simply claimed that “damage” to the hepatic duct was one of the risks of gallbladder surgery. He also claimed that the woman’s hepatic duct and cystic duct were very close together, and that this unusual circumstance made it difficult for him to distinguish the two ducts. In other words, he seemed to argue that it was the woman’s own fault for having her ducts so close together!

The woman’s legal team argued that there were ways to identify the proper duct before cutting, such as an intraoperative cholangiogram, which involves inserting a catheter into the duct and injecting it with X-ray dye.

Pennsylvania medical malpractice attorneys following the news of the case were pleased to note that the jury agreed with the plaintiff: the cutting of the hepatic duct was an avoidable error. The jury awarded the woman $70,393 for past medical expenses and $179,607 for pain and suffering.

Source: Napa Valley Register “Woman receives $250,000 in malpractice suit” 1/21/2011

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