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Perforation of Aorta
Discussion in 'All Categories' started by Rakesh Tandan - May 26th, 2014 6:08 am.
Rakesh Tandan
Rakesh Tandan
Dear Sir,

My wife was operated for laparoscopic cholecystectomy 3 month ago in Agra. The surgeon had been given a demonstration of a new trocar instrument and not had the opportunity anytime before to know or practice that new instrument and foreseen to use it. During the introduction of trocar he has perforated the aorata. Once the condition of my wife became unstable then an open laparotomy was performed by same hospital which revealed a probable aortic injury. After second surgery in same hospital my wife was transferred to a larger centre where a surgical exploration confirmed a through and through injury to the aorta and partial damage to the renal vein. My wife suffered a lot and ultimately died with suffering one months later. I want to take legal action against the doctor and hospital. Please advice me what should I do?
re: Perforation of Aorta by Aditya Rajeshwar - May 26th, 2014 7:13 am
Aditya Rajeshwar
Aditya Rajeshwar
Dear Rakesh Tandan

One of the most frequent malpractice medico legal claims filed against laparocopic surgeons all over world involves an injury that occurs during or as a result of elective laparoscopic surgery and majority of them is during access technique. These claims are often defended on the basis that the injuries were complications from the surgery. The complainant said fact is always that the injury was not a complication, but the consequence of medical negligence. The outcomes of those malpractice cases often turns on the phrase an excusable complication means this is one incidence in which the surgeon is not legally liable for the patient injury.

Many laparoscopic surgeons want to broadly define complication to mean that when the injury has occurred with other patients under similar circumstances, the appearance of the injury in the present case is not the consequence of a negligent act but clearly written in the book that it is a known complication and even reported in the book. These defenses are usually supported by data in the medical literature citing the frequency from the complication. Some physicians make reference to such adverse outcomes as known complications which were understood and accepted by both sides before surgical intervention.
We have not examined the OR note of your wife but many things has to be kept in mind. Is the access technique during laparoscopic surgery was appropriate to your wife? During the open surgery in the same hospital inspection from the peritoneal cavity demonstrate controlled hemostasis? We need to examine the operative note written by the laparoscopic surgeon and also the post-operative progress note within the permanent medical record of the hospital which will reflect any significant surgical or technical difficulties encountered in the laparoscopic procedure? If bleeding complication during access of trocar inside the abdomen of your wife is encountered, did the hospital management has have a back-up plan to address this complication? Is an investigation or referral to higher center after first complication indicated to eliminate potential vascular/hemorrhagic complication? After complication an extended period of monitoring was done or not as required and is mandatory following complication a laparoscopic procedure?

In these circumstances only a careful examination of all the hospital record is required. I hope you must have understood the situation. Please do not hesitate if you have any other question.

Aditya Rajeshwar. LL. B

re: Perforation of Aorta by Ankita Thakur - May 26th, 2014 7:25 am
Ankita Thakur
Ankita Thakur
In this case what is the definition of complication and negligence. How any body can prove that it is a complication?
re: Perforation of Aorta by Martin - May 27th, 2014 12:26 pm
I this patient should get compensation in this case.
re: Perforation of Aorta by Stiven - May 27th, 2014 12:28 pm
How do you know that surgeon was using this trocar first time and he was demonstrating to others?? Did the surgeon accepted this fact.
re: Perforation of Aorta by Subramanyam Swami - Jun 5th, 2014 7:57 am
Subramanyam Swami
Subramanyam Swami
Excellent case discussion but Iatrogenic Injury is accepted truth all over World. Adverse events in laparoscopic surgery is never reported systematically by any agency, like aviation accidents or vehicle accidents, and the scope of the problem has never been correctly defined. Doctors culture also need to be defined to strive for error-free practice. Making an error by doctor is seen as a failure of treatment and there is a reluctance to report adverse events for fear of individual blame and litigation by medical profession.
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