Facts

In September 2004, plaintiff Jeanette Soto, a 46-year-old court reporter, was referred to a gynecologic oncologist, defendant Margarett Ellison, for a growing ovarian mass. Defendant removed plaintiff's right ovary and uterus in November in a laparascopic assisted hysterectomy. Pathology revealed a benign ovarian cyst less than 2 centimeters. The plaintiff felt ill and did not recover as expected from the surgery. A CT scan performed on the 4th day Post Op revealed a perforated bowel, for which defendant performed a second surgery.

The defendant elected to remove plaintiff's umbilicus to bring the colostomy out. The plaintiff became ill after the operation and required blood transfusions. She was diagnosed with pneumonia and phlebitis after the surgery, but suffered from subphrenic abscesses above the liver in the subdiaphragmatic space. She had a third surgery 21 days later to drain the abscesses. She was discharged with IV antibiotics and home nursing instructions to care for the colostomy. The plaintiff suffered wasting after prolonged sepsis and required a feeding tube. Three months later, she underwent a fourth surgery to reverse the colostomy. The plaintiff sued defendant for medical malpractice.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended defendant negligently performed the operations without plaintiff's informed consent. She also failed to provide a diagnosis of the subphrenic abscess and failed to act promptly once the suphrenic abscess was identified on the CT on the 15th day. The defendant never discussed removal of the plaintiff's ovary alone in a more simple procedure or the relative risks of oopherectomy alone versus removal of ovary and uterus or the option of watchful waiting. Instead, she offered only the removal of the ovary and hysterectomy laparoscopically.

Plaintiffs alleged that because the surgeon did not have a clear view of the surgical field, and missed the second ovary, she should have converted from a laparoscopic to an open procedure. The defendant would then have discovered the bowel perforation intraoperatively and the presence of two ovaries.

The surgeon did not see plaintiff post-operatively or address her complaints regarding her slow recovery. The defendant failed to explain the risks of using a low transverse Pfannensteil incision for cosmesis to correct the perforation rather than the incision preferred by bowel and general surgeons, a less attractive midline incision that provides access to the whole abdomen. She performed the operation without plaintiff's informed consent, negligently making a transverse Pfannensteil incision at the level of the pubic bone rather than a vertical one at the midline. This made it more difficult to remove the fecal matter from the upper intestine and resulted in two abscesses at the top of the abdomen in the subdiaphragmatic/subphrenic space.

The defendant also failed to inform plaintiff she was electively removing the umbilicus and would require plastic surgery. The plaintiff never consented to the medically unnecessary step.

DEFENDANT'S CONTENTIONS:
The defendant contended plaintiff's treatment fell within the standard of care. She fully informed plaintiff and received her consent for each procedure, performed by multiple physicians. The defendant denied removing the umbilicus.

Specials in Evidence

$20,000 for reconstructive plastic surgery; $12,000 for out of pocket medical expenses. $138,000;

Damages

The plaintiff sought damages for lost wages, medical expenses, and an unspecified amount for past and future pain and suffering.

Injuries

The plaintiff suffered from multiple injuries as a result of defendant's negligence, including colostomy; subphrenic abscesses; thoracentesis; prolonged sepsis; weakness; wasting; and hair loss, precluding her from returning to work or accepting after-court transcript work for a period of time.

Result

The jury returned a defense verdict, finding defendant was not negligent and obtained plaintiff's informed consent before both surgeries.

Deliberation

one hour

Length

eight days