Final Verdict: Surgical Mistake From Delay
Physicians have a grave responsibility to make the best possible decisions for all of their patients. This includes not only the correct treatment, based on careful diagnosis and evaluation of symptoms, but the correct course of treatment. An intervention which is suitable for one patient may not be suitable for another with contraindications of certain susceptibilities, and a treatment which would work under one situation will not work in the same way if it is delayed.
In September of 2012, 56-year-old Yvonne Fletcher of the District of Columbia was admitted to Providence Hospital with severe abdominal pain. A CT scan showed that Yvonne was suffering from appendicitis, and she was scheduled for an appendectomy with general surgeon William J. Brownlee. The surgery took place the following evening around midnight. However, the delay caused appendicitis to worsen, and the organ ruptured during the surgery. Infected fluid spread throughout Yvonne’s body cavity, causing the surgeon to be unable to complete the surgery safely. In the process, Dr. Brownlee lacerated her bladder.
A second surgery allowed for the bladder to be repaired, but Yvonne reported permanent urinary damage, including permanent chronic urinary urgency. After recovering from the second surgery, Yvonne hired attorneys Scott Perry and Leslee Soudrette. They sued Dr. Brownlee and the hospital, alleging surgeon malpractice, hospital malpractice, surgical error, failure to treat, delayed treatment, and negligent treatment.
In her claim, Yvonne argued that the delay in treatment had caused her serious injuries. Rather than arriving the same day as the CT scan, Dr. Brownlee had waited, ordering a second CT scan the following morning and not seeing her until 5 PM the day after she arrived. Experts brought by Yvonne’s attorneys argued that the burst appendix obscured the surgical field and made the surgery unsafe. They also argued that the entire process put Yvonne at heightened risk because she was exposed to the infectious process of the burst appendix for a lengthy period of time.
They also argued that the hospital should have performed diagnostic testing sooner in order to decrease the delay in receiving the necessary treatment.
Experts presented for both Dr. Brownlee and the hospital. Dr. Brownlee’s experts argued that bladder perforation was a known risk of appendectomy and that the rupture took place as the appendix was removed, not as a result of the delay. They also attempted to argue that the risk of infection was low and that she did not ultimately suffer any ill effects from the event, and said that neither the hospital nor Dr. Brownlee breached any ordinary standards of care.
The trial lasted for six days and was adjudicated by eight jurors in Washington, DC. After closing arguments, the jury deliberated for six hours, carefully weighing the arguments made by Yvonne’s attorneys, by the attorneys for the hospital, and the attorneys for Dr. Brownlee. They returned to the courtroom and entered a split verdict, finding that the hospital made no breaches in the ordinary standard of care, but that Dr. Brownlee had been negligent in causing the unnecessary delay and in performing the surgery. They found a defense verdict for the hospital but awarded a total of $494,250 to Yvonne and her husband against Dr. Brownlee. Cohen & Cohen