"Subclavian" port-a-cath is placed in the thoracic aorta (Case #130)

• Medical Probability: 9 / 10
• Medical Error Summary: I am a general surgeon who places approximately 50 ports a year. My preferred route is the left subclavian approach as in this case. It is extremely likely that a medical error was performed because t...
• Causation Probability: 10 / 10
• Causation Summary: If the patient required open heart surgery then the only reason why that would have been necessary would have been to remedy the incorrect catheter placement
• Expert Summary: Intimately familiar with the procedure and it's alternative routes for placement. I am also intimately familiar with the legal aspects of incorrect placement. Over my practice I've probably placed ove...
• Similar Summary: In my practice it has never happened to me personally. However, I'm aware of other instances when this has happened.

Testicular ischemia following inguinal hernia repair (Case #172)

• Medical Probability: 9 / 10
• Medical Error Summary: The loss of the testicle had to have occurred for one of two reasons: Either the testicular artery was cut, coagulated or damaged within the spermatic cord or a suture was placed around it at some poi...
• Causation Probability: 10 / 10
• Causation Summary: The loss of the testicle is a direct result of the damage to the blood flow to the testicle. Testicular loss can't happen without a technical error that interrupts the blood flow.
• Expert Summary: Extensive experience in the performance of inguinal hernia repairs with 30 years of surgical experience. Also experienced in forensic cases.
• Similar Summary: Loss of testicle never since it's a rare complication and a direct result of a surgical error. However, the performance of inguinal hernia repairs I perform commonly.

Right hemicolectomy following appendiceal adenocarcinoma (Case #175)

• Medical Probability: 6 / 10
• Medical Error Summary: I would have to believe that the patient was not on prophylaxis for deep vein thrombosis and that he developed a blood clot during his hospitalization. If in fact, the patient was not on heparin or L...
• Causation Probability: 10 / 10
• Causation Summary: If the patient was not on prophylactic heparin or Lovenox then definitely that omission caused the massive pulmonary embolus.
• Expert Summary: General surgeon with extensive experience in colorectal surgery, and laparoscopic surgery.
• Similar Summary: Appendiceal carcinoma is not a very common disease so it is not a frequent case in anybody's practice. However the issue of prophylactic anticoagulation is pertinent to every operation performed so f...

Colon perforation while inpatient (Case #316)

• Medical Probability: 10 / 10
• Medical Error Summary: It appears that the patient had not improved, or even worsened since her admission on 7/13. The CT scan from 7/20 at 1 PM showed bowel obstruction with a transition point and persistent Sigmoid colon ...
• Causation Probability: 10 / 10
• Causation Summary: There was a 48 hour delay in getting this patient to the OR. During that delay the patient perforated her colon precipitating irreversible sepsis and death. Had the patient been taken to the OR at the...
• Expert Summary: Extensive experience in colonic, small bowel and abdominal surgery
• Similar Summary: 75 to 100 times a year. However, as of 2019 I limited my practice to breast surgery and since then have not performed colonic surgery. Prior to that colon, small bowel and abdominal surgery was freque...

Bilateral hernia mesh placement with complications (Case #337)

• Medical Probability: 9 / 10
• Medical Error Summary: In his operative report the surgeon confirmed there was no hernia on the left side but proceeded to place a mesh. The only indication to place a mesh is if there is a hernia. Placement of mesh caries ...
• Causation Probability: 9 / 10
• Causation Summary: Since there was no indication for a mesh and it resulted in complications then the error by the surgeon was a direct cause of the complication.
• Expert Summary: Busy general and oncologic surgeon who performs many hernia repairs both open, robotic and laparoscopic. Also have 25 years of experience as a forensic expert and review about 6 cases a year.
• Similar Summary: 30 to 40 times a year. Prior to 2019 I would perform over 100 hernia repairs a year.

Surgical Resection- Mass in Colon (Case #348)

• Medical Probability: 10 / 10
• Medical Error Summary: There are several problems with the conduct of the operation. There is no mention of the first surgeon opening the specimen within the operating room in order to confirm the intended target has been e...
• Causation Probability: 10 / 10
• Causation Summary: The complication was caused by the unresected polyp that occluded the anastomosis. Had the polyp been removed, there would not have been a polyp to occlude the anastomosis.
• Expert Summary: I'm a board certified general surgeon and surgical oncologist with extensive experience in open colectomies, laparoscopic colectomies and robotic colectomies.
• Similar Summary: Up until 2020 I encountered this problem between 50 to 75 times a year. Since 2020 I no longer perform colonic surgery

Potential deviations in the SOC for surgical care in left scout-assisted lumpectomy with SLNB (sentinel lymph node biopsy). (Case #529)

• Medical Probability: 2 / 10
• Medical Error Summary: Considering the short interval between presentation and the presence of metastatic disease, it is likely the cancer was metastatic at presentation. The chosen surgery, the intra-operative decisions an...
• Causation Probability: 1 / 10
• Causation Summary: The type of cancer (Luminal B), high oncotype and short interval between presentation of the cancer and the identification of metastatic disease indicate the metastases were already established at pre...
• Expert Summary: I am a fully trained surgical oncologist practicing exclussively breast surgery in a high volume practice. I have been in practice since 1988 so I have an extensive experience in this area. I evaluate...
• Similar Summary: This type of case is extremely common in my practice. As mentioned above, I evaluate about 225 new breast cancer cases per year, of which about 70 % are hormone receptor positive, her2neu negative.