Patient dies after prostatectomy; is his urologist at fault?


Dawn Collins, JDA 67-year-old New York man underwent a prostatectomy in 2011. The procedure was done laparoscopically to address an enlargement of the prostate. He subsequently developed a recto-urethral fistula and, a few months later, he underwent an ileostomy. The patient died the following year, but his death was not related to his fistula or its residual effects. 

Also by Dawn Collins, JD: Did on-call’s refusal to provide consult lead to loss of testicle?

A lawsuit was filed on behalf of the man’s estate and alleged the urologist failed to properly treat the patient. The expert opined that the patient should not have undergone this procedure and that the laser caused a breakdown of tissue, which decreased the vascular flow in the surrounding area that resulted in the fistula.

The urologist’s expert opined that the procedure produced minimal destruction of tissue and concluded that the procedure did not reach the area that developed the fistula. He also opined that the procedure was safer than transurethral resection of the prostate. The jury returned a defense verdict.

Related: How spoliation of evidence can cost you in court

LEGAL PERSPECTIVE: In this case, it came out in testimony that the patient had previously undergone radiation treatment to a cancerous region of the prostate, and it was alleged that the radiation had compromised the tissue in the surrounding area. This pre-existing damage could have contributed to the fistula and the need for ileostomy.

Next: Claim that prolonged laparoscopic procedure caused hip pain


Claim that prolonged laparoscopic procedure caused hip pain

A 71-year-old Missouri man was suffering from stage III kidney cancer in 2009. He underwent a robotic laparoscopic partial nephrectomy to remove the tumor from his kidney. The procedure lasted 5½ hours and was immediately followed by a hernia repair that lasted another 2½ hours. Subsequently, the man complained of pain and numbness on his right side and right hip. He has been cancer free for 6½ years.

Also see - Offensive disclosure and defensive medicine: What you need to know

The man sued the urologist who performed the operation and alleged that he should have converted from a laparoscopic to an open procedure to shorten the length of surgery to prevent injury to other areas. He claimed the long operation time increased the chance of muscle breakdown and alleged he developed rhabdomyolysis.

The urologist argued that the length of the operation was related to removal of the tumor. He further contended that the patient had since received two operations on his spine and that these and other events associated with them could have provided another explanation for the patient’s pain. The jury returned a defense verdict.

More from Urology Times:

Patient sues after arterial injury during nephrectomy

How continuous treatment rules can make lawsuits thrive

Could necrotizing fasciitis have been diagnosed sooner?

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