The plaintiff secured a verdict on behalf of a 49-year-old disabled woman who died from a delayed diagnosis and treatment of a bowel obstruction.
The case raised difficult questions about clinical judgment, informed consent, and how juries value life in the face of significant medical and psychosocial complexities.
The decedent had been admitted to local hospitals more than 20 times over two years, frequently presenting with abdominal pain, vomiting and X-ray findings interpreted as ileus or partial bowel obstruction. Conservative management had been effective in the past and became the default.
That approach continued during her final hospitalization at Ascension St. John Oakland in late 2016. She presented twice within eight days with worsening abdominal symptoms. On her first visit, an X-ray suggested obstruction, but a CT scan was inconclusive. She was admitted, diagnosed with C. difficile, and discharged two days later.
When she returned with persistent symptoms and no bowel movements, she was again managed non-operatively. Although she was seen daily by surgery, no CT was performed until Dec. 7, after a sharp decline in her vitals. Emergency surgery revealed bowel perforation, necrosis and sepsis. She died shortly thereafter.
The defense relied on a framework called “ICE” — Imaging, Condition and Examination — arguing that the patient’s clinical picture didn’t justify surgery until the day it was performed. The defense emphasized her poor surgical candidacy due to obesity, depression and prior suicide attempts.
Plaintiff’s counsel argued that traditional imaging is often unreliable in patients with prior Roux-en-Y gastric bypass, and that only an exploratory laparotomy could have revealed the obstruction in time. That position was supported by Schwartz’s Principles of Surgery, SESAP and other surgical literature.
The plaintiff also pointed to inconsistencies between the physicians’ progress notes and the nursing records, which documented continued deterioration.
A central theme in the case was informed consent. The plaintiff contended that surgery was never discussed with the patient, depriving her of the opportunity to choose a potentially life-saving intervention.
Despite the defense’s emphasis on limited damages — the decedent was unmarried, childless, disabled and unable to live independently — the jury found liability and recognized the value of the chance she was never given.
Plaintiff’s counsel provided the case information.