Bowel Perforation: Malpractice or Recognized Complication?

By: Attorney Andrew M. Rockman

Surgical procedures such as tubal ligation or other operations in the abdominal area, including actual surgical entrance into the abdomen, sometimes lead to bowel perforation.

A substantial number of people have come to me over the years with the firm belief that the bowel damage they suffered had to be proof of malpractice.

Simply put: not so. Although in some instances, putting a hole in the bowel might very well be malpractice, proving that may be quite difficult. Many surgeons will tell you that it is often a recognized, unintended but unavoidable complication of many surgical procedures. The argument usually is that the surgical field or area of the operation does not present a pristine picture book like view. It is one of blood and tissues, with the surgeon facing an impeded ability to see everything in the area of the procedure. This leads to recognition that sometimes an abdomen containing adhesions or tissues that are stuck together from previous surgery or illness, creates an unavoidable risk of perforation or damage.

As an experienced medical malpractice attorney, I have found that the more likely area of malpractice or substandard care is in the failure of the surgeon to recognize the perforation or bowel damage in time and to immediately respond to correct the situation. Symptoms such as abdominal distention or swelling of the abdomen, certain changes in the blood work, pain and signs of infection are the alerts that require immediate intervention. Failure to recognize that a perforation has been caused leaves the patient open to a runaway infection, internal damage, and sometimes death. 

It is the surgeon’s obligation to recognize the signs and symptoms of a damaged bowel so that the problems that can result are stopped before the contents of the bowel or germ-laden materials abdomen, sometimes preventing the ability to correct before permanent damage is caused.

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About the Author
Attorney Andrew M. Rockman, chairs the Medical Malpractice Department at the Princeton-based law firm of Pellettieri, Rabstein & Altman and has earned an “AV” rating by the Martindale-Hubbell Law Directory.

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