A 46-year-old woman with a history of uterine fibroids and menorrhagia underwent a total abdominal hysterectomy with bilateral salpingectomy during which the surgeon transected the patient’s right ureter and also sutured her bladder wall to the vaginal cuff, which resulted in the complete perforation of her bladder. The surgeon failed to discover the transected ureter or the perforation of the bladder before concluding the surgery.
The patient went to the hospital emergency room several days later after she experienced leaking from her surgical wound. The ER medical staff observed that the woman had a distended abdomen and hypoactive bowel sounds. An abdominal CT scan was ordered and showed a collection of 4 cm of fluid in the patient’s right posterior pelvis as well as air in her bladder.
The original surgeon was advised of the patient’s symptoms and CT findings which led him to instruct that the patient be admitted to the hospital for exploratory surgery to be performed the following morning by a urologist. When the surgeon was advised the next morning that no urologist was available to perform the exploratory surgery/repair, the original surgeon had the patient transferred to another hospital where the repair surgery could be performed.
The plaintiff was diagnosed at the receiving hospital with perforation of the right posterior bladder wall. She had repair surgery performed by a urologist and a urological oncologist who confirmed during the repair surgery that the bladder wall was sutured to the vaginal cuff, that multiple perforations in the bladder had occurred during the hysterectomy, and that the right ureter had been transected.
Following the repair surgery, the woman’s recovery was long and complicated by kidney infections and multiple episodes of ureteral obstruction. She continues to suffer from urinary urgency, leakage and frequency. She may also require a nephrectomy in the future.
The woman’s experts were prepared to testify during trial that the defendant breached the standard of care by causing the injury to her bladder and ureter as well as by failing to discover the injuries to her bladder and ureter during the surgery. Had the defendant surgeon discovered the unintended injuries and a urologist called in to repair the injuries during the surgery, then the woman would have avoided the harm she suffered, according to the plaintiff’s experts.
The plaintiff claimed $237,395.73 in economic damages. The Virginia medical malpractice case was settled for $1 million in November 2023 before the parties designated their respective experts.
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