Articles Posted in Vascular Surgery

In a case being reported with a confidentiality agreement, Doe, age 15, developed a mass on the bone of her left middle finger, for which orthopedic surgeon Dr. Ronald Hillock recommended surgery.

During the outpatient procedure, Dr. Hillock used a latex Penrose drain to place a tourniquet around Doe’s finger. While in the recovery room, a nurse noted that Doe’s finger looked discolored; however, Hillock discharged Doe.

Doe had several follow-up appointments with Dr. Hillock in the next few weeks but the finger remained discolored. Doe consulted a different doctor about 30 days after the surgery. That physician diagnosed ischemia and later performed a finger amputation.
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Donne Licudine, 20, was diagnosed with cholecystitis, the inflammation of the gallbladder. The gallbladder is the small organ near the liver that plays a part in the digestion of food. When the condition is acute, the patient experiences upper abdominal pain and there is usually an obstruction of the cystic duct.

Because of her medical condition, a general surgeon, Dr. Brendan Carroll, and a resident, Dr. Ankur Gupta, did a laparoscopic cholecystectomy, which is the surgical procedure that removes the gallbladder. During that surgery, it was first discovered that Licudine had suffered a vascular injury. The doctors converted to an open procedure, which revealed a torn iliac vein. As a result, Licudine required three surgeries to repair her vascular injuries.

Licudine was a college rower. She was obviously a very active athlete. She now suffers from bowel adhesions, a six-inch scar from her abdomen to her sternum and severe depression as a result of her injuries. Licudine had planned to attend law school but has canceled those plans due to her medical condition.

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On April 29, 2004, 36-year-old Tamara Greico sprained her ankle during a bowling match. She was diagnosed in the emergency room of a hospital with a severe ankle sprain. She had wrapped it and was given crutches and told to keep her ankle elevated before being referred to an Alton, Ill., clinic.

The physician’s assistant and medical assistant at the clinic testified at the jury trial that they saw Tamara the next day and made a similar diagnosis while also giving her a walking boot, medication and instruction for exercising the ankle. Tamara returned to the clinic on May 5, 2004 complaining of more pain and numbness in her toes. A physician and one of the defendants, Dr. Bruce Vest, testified that he examined her and considered the possibility that she had a deep vein thrombosis, a blood clot, but ruled it out and did not order anticoagulant therapy.

Two days later, Tamara’s employer found her lying on the ground near her car in the office parking lot, lapsing in and out of consciousness. She was taken to the hospital where she complained of breathing problems before going into cardiac arrest.

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Kevin Tolson was 49 years old when he was injured as the collapsible barrier he was walking over suddenly shot upward, entangling him. He was taken to the nearby hospital emergency room where he experienced symptoms, which included a cold left foot that he was unable to move, numbness and tingling in the foot as well as severe pain. X-rays were completed and a physician assistant diagnosed knee strain and released Tolson from the hospital with instructions to see an orthopedic surgeon.

When Tolson’s symptoms persisted, he consulted a local doctor who detected low pulse in his leg and instructed him to return to the hospital. An MRI revealed that all of the ligaments in Tolson’s left knee were damaged. Despite surgery, Tolson’s leg had to be amputated above the knee. He had been a security guard working two jobs at about $20 an hour, but is now able to hold only one position due to his medical condition.

Tolson sued the physician assistant and emergency room physician at the hospital and also named the hospital as a party defendant. It was alleged in the lawsuit that these medical providers chose not to diagnose a popliteal artery injury. Tolson claimed that based on his symptoms and the x-rays that were taken at the emergency room a dislocation and possible vascular injury could not be ruled out.

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Guadalupe Ramirez had a history of congestive heart failure.  She was also an insulin-dependent diabetic, had mitral valve regurgitation, atrial fibrillation, rheumatic heart disease, high blood pressure and a prosthetic heart valve.  Ramirez, 72, underwent a cardiac catheterization procedure on Nov. 21, 2003.  Eight days after the procedure, Ramirez presented to the emergency department at the University of Illinois Hospital (UIC) complaining of groin pain.

The defendant, Dr. Joan Briller, was the attending cardiologist for the first 24 hours of her admission.  Dr. Briller and other physicians considered a retroperitoneal bleed in their assessment, but did not order a CT scan until about 22 hours later.

All parties agreed that a retroperitoneal bleed is a recognized complication of cardiac catheterization and often occurs in the absence of negligence.

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