Death from shock and multi-organ failure after motorcycle accident (Case #341)

• Medical Probability: 9 / 10
• Medical Error Summary: The fact that the patient received an incompatible blood transfusion is itself a medical error. Upon arrival to the emergency department, blood samples are obtained from trauma patients for type and c...
• Causation Probability: 8 / 10
• Causation Summary: It seems from the information provided that the patient died from untreated anaphylactic shock. Also, it is stated that the patient has distributive shock with unknown etiology and other forms of shoc...
• Expert Summary: I am an academic trauma surgeon working at an ACS certified trauma center. I am double board-certified in general surgery and surgical critical care. Active clinical practice with nearly a decade of e...
• Similar Summary: I encounter critically injured trauma patients on a daily basis. My practice involves acutely injured patients from motorcycle and motor vehicle accidents and all forms of blunt and penetrating trauma...

Surgical Resection- Mass in Colon (Case #348)

• Medical Probability: 8 / 10
• Medical Error Summary: According to the records provided, the ink tattoo is placed 15 cm distal to the mass and the proximal colonic transection point was done 8 cm proximal to the tattoo. This was followed by a postoperati...
• Causation Probability: 9 / 10
• Causation Summary: The fact that an immediate postoperative colon obstruction occurred at the site of the anastomosis indicates that a surgical error has occurred and the fact that it required a return to the operating ...
• Expert Summary: I am an academic surgeon in active clinical practice who performs routine intraabdominal surgery including bowel resections, anastomosis and ostomy creation on a daily basis. I have nearly a decade of...
• Similar Summary: I encounter cases similar to this in my practice on a daily basis.

Death from diffuse alveolar hemorrhage over two months after motorcycle crash (Case #350)

• Medical Probability: 4 / 10
• Medical Error Summary: After sustaining life-threatening injuries and a prolonged hospital stay, the patient had significant recovery and was ready for discharge. She then developed fatal pulmonary hemorrhage more than two ...
• Causation Probability: 3 / 10
• Causation Summary: The patient had major recovery from significant injuries and succumbed to life threatening pulmonary hemorrhage months after initial presentation. As it is unlikely that there was a medical error, it ...
• Expert Summary: I am an academic trauma surgeon in active practice for nearly a decade. I manage critically injured patients on a daily basis.
• Similar Summary: I manage critically injured patients similar to the one described on a daily basis.

Abdominal bleed/anastomotic leak (Case #357)

• Medical Probability: 7 / 10
• Medical Error Summary: The initial presentation can be interpreted as an anastomotic bleed based on the patient presentation (bleeding per rectum), initial vital signs (indicative of hemorrhagic shock), and lab values (low ...
• Causation Probability: 7 / 10
• Causation Summary: While the patient initially presented as an anastomotic bleed, the patient developed a leukocytosis (elevated WBC) up to 21 the following day, concerning for a leak. There needs to be more information...
• Expert Summary: I am truthful and objective. Academic Trauma Medical Director and medical expert witness. I am in active clinical practice of general surgery with nearly a decade of experience.
• Similar Summary: I see this on a weekly basis. I also take care of them in the icu, as I am specialized in surgical critical care as well.

Possible failure to transfer to trauma center for trauma involving chest injuries with resultant death due to pulmonary decompensation and arrest. (Case #358)

• Medical Probability: 8 / 10
• Medical Error Summary: This patient had blunt chest wall trauma - this is a survivable injury. The fact is that the extent of trauma should not lead to mortality. When the patient had the repeat CT scan, the patient shoul...
• Causation Probability: 8 / 10
• Causation Summary: This patient should have been admitted to the icu of a verified trauma center with thoracic surgery capabilities. The patient had complex blunt thoracic trauma - most commonly is not life-threatening ...
• Expert Summary: I am truthful and objective. Academic Trauma Medical Director in active clinical practice of trauma and critical care.
• Similar Summary: Simple thoracic trauma is something I manage every day. More severe thoracic trauma to this magnitude will occur every few weeks.

During a routine hernia repair, surgeon mistakes PC's urethral sphincter prosthetic fluid reservoir for an abdominal seroma and does needle aspiration., damages prosthetic. (Case #374)

• Medical Probability: 10 / 10
• Medical Error Summary: The surgeon had no business aspirating anything during a robotic ventral hernia repair. The fact that it was even considered, let alone actually performed, is indicative of an obvious error. In additi...
• Causation Probability: 10 / 10
• Causation Summary: Absolutely. The fluid aspirated from the device immediately led to urinary incontinence. The fact that he lost urinary continence during the case and had to insert a Foley intraoperatively is another ...
• Expert Summary: I have.been board certified for ten years and in active practice where I perform robotic hernia repairs routinely. I am the Department of Surgery Chair.
• Similar Summary: I perform robotic surgery on a daily basis and I routinely perform hernia repairs.

Young male needs CVC for sickle cell treatment, surgeon perforates subclavian artery bedside, has multiple complications (Case #376)

• Medical Probability: 10 / 10
• Medical Error Summary: The subclavian artery injury was directly resulted from this procedure. Other questions to consider: - Did the surgeon attempt IJ or subclavian? - How many attempts were made? - Did the surgeon...
• Causation Probability: 10 / 10
• Causation Summary: The injury led to massive hemorrhage and hemorrhagic shock. The injury is directly related to the procedure. Here is what can be said about causation in this case: res ipsa loquitur
• Expert Summary: I am a trauma/critical care surgeon and I perform this procedure regularly. I am dual board certified in general surgery and surgical critical care. I am the Trauma Medical Director and Depart...
• Similar Summary: Central venous catheters is part of my daily practice.

Injury to the aorta inferior mesenteric vein, jejunum during elective robotic assisted laparoscopic sleeve gastrectomy (Case #397)

• Medical Probability: 10 / 10
• Medical Error Summary: Injury to bowel and blood vessels in the abdomen are a know possible complication of laparoscopic surgery. Typically, the patient is informed and consented that those injuries could potentially oc...
• Causation Probability: 10 / 10
• Causation Summary: The error (which was a technical intraoperative error) did cause harm to the patient by virtue of the injury that was sustained and the fact that the patient was then subjected to additional surgery a...
• Expert Summary: I perform laparoscopic surgery on a daily basis. I have been in practice for nearly a decade. I am the Chair of the Department of Surgery. I have been a medical expert witness in multiple ...
• Similar Summary: I perform laparoscopic surgery daily. I perform acute care surgery, oftentimes managing patients with complications. I work in an academic center, where I teach surgical trainees on operative ...

Failure to properly monitor patient for potential bowel perforation following MVA and discharging early. (Case #421)

• Medical Probability: 8 / 10
• Medical Error Summary: The patient was transferred to the trauma center with abdominal pain and a CT scan demonstrating bowel injury and intraabdominal fluid after an MVC. The patient should have undergone diagnostic la...
• Causation Probability: 10 / 10
• Causation Summary: Had a diagnostic laparoscopy or laparotomy been performed at the time of initial presentation, the bowel perforation would have been treated sooner. This is a case of delay in diagnosis. The misse...
• Expert Summary: I routinely manage cases just like this. I also have many years of experience as a surgeon and expert witness.
• Similar Summary: I manage patients with bowel perforation on a daily basis.

Review by board certified critical care surgeon for delayed compartment syndrome diagnosis and treatment of right foot. (Case #526)

• Medical Probability: 6 / 10
• Medical Error Summary: With the clinical suspicion of compartment syndrome, there should have been an attempt to transport the patient to the nearest trauma center, not necessarily the trauma center within the same healthca...
• Causation Probability: 8 / 10
• Causation Summary: The delay in transport led to a delay in definitive care, of which compartment syndrome requires time-sensitive intervention to prevent permanent and irreversible damage to the extremity.
• Expert Summary: I am the Trauma Medical Director and Department of Surgery Chair at a Level II Trauma Center. I have provided medical expert witness services for both plaintiff and defendant for years and have ex...
• Similar Summary: As Trauma Medical Director and an actively practicing trauma surgeon, I encounter cases similar to this on a regular basis.