Illinois Jury Finds in Favor of Doctor in Gallbladder Surgery that Led to Fatal Bowel Perforation – Nickl v. Barry S. Rosen, M.D.

Some people assume that whenever there is a negative medical outcome that it is the result of medical negligence. However, in some cases there can be a poor outcome without the presence of medical malpractice. Take for instance the Lake County medical malpractice lawsuit of Estate of Patricia Nickl v. Dr. Barry S. Rosen, 08 L 1015, where the jury found in favor of the defendant doctor.

The case of Nickl arose after the 64 year-old decedent, Patricia Nickl, died within days of undergoing surgery performed by the defendant, Dr. Rosen. Nickl had a longstanding history of abdominal and gallbladder problems and had already undergone four major abdominal surgeries. These prior surgeries were a significant piece of Nickl’s medical history because it increased the number of adhesions in her abdomen. Adhesions are bands of scar tissue that tend to form around surgical sites. Because the adhesions bond together areas that weren’t previously joined, they tend to complicate surgeries and increase the risk for perforations, or holes.

However, despite the large number of adhesions in Nickl’s abdominal cavity, she was still eligible for a laparoscopic cholecystectomy, i.e., the surgical removal of her gallbladder. The surgery itself was successful, but Nickl suffered from some post-operative complications. She remained hospitalized for several days longer than anticipated because of persistent pain and a lack of bowel movement.

Nickl’s hospital course took a turn for the worse when she began developing atrial fibrillation, i.e., an irregular heartbeat, just two days following her surgery. Given the irregular heartbeat and the presence of severe abdominal pain, Dr. Rosen elected to take her back to the operative room to conduct an exploratory laparotomy to try and diagnose the source of her pain.

However, before the exploratory procedure could begin, Nickl went into a medical emergency and needed to be revived. After reviving Nickl, Dr. Rosen was able to perform the exploratory laparotomy, which revealed a small colon perforation. Dr. Rosen surgically repaired the hole, but that did not reverse Nickl’s deterioration. The next day she suffered from another medical emergency; while doctors were able to revive Nickl, she ended up dying later that day.

An autopsy revealed that Nickl’s death was the result of sepsis and multiple-organ failure, both of which could be attributed to the colon perforation made during the initial surgery. Given these results, Nickl’s surviving family members filed an Illinois wrongful death lawsuit against Dr. Rosen, alleging that he chose not to adequately or carefully manipulate the bowel and identify the perforation prior to closing the surgical site.

In his defense, Dr. Rosen testified that he spent approximately one and a half hours removing adhesions from Nickl’s abdominal area before even proceeding to the gallbladder removal portion of the surgery. Dr. Rosen also pointed to his operative report, which confirmed that he and his team had reexamined the area for perforations prior to closing the surgical site.

Dr. Rosen’s medical expert collaborated Dr. Rosen’s own testimony, stating that Dr. Rosen was meticulous in the way he evaluated the bowel during the procedure. Furthermore, the expert stated that in his opinion the bowel perforation was not observable and did not actually manifest itself until the morning of the exploratory laparotomy procedure.

In support of his defense, Dr. Rosen also opined that Nickl had suffered from an unrecognized bowel injury, which he testified was a known complication of the surgery. Likewise, Dr. Rosen suggested that Nickl would have survived the bowel perforation if not for her previously undetected heart disease, which was only discovered upon autopsy.

The decedent’s estate disagreed with Dr. Rosen’s explanation and insisted that Nickl’s death was the result of surgical negligence. It asked the Lake County jury to award a $1.5 million verdict to the surviving family members for the loss of Nickl. However, the jury did not find any medical negligence and instead entered a not guilty verdict in favor of Dr. Rosen.

Chicago’s Keisman Law Offices has been handling Illinois wrongful death cases for more than 35 years for individuals and families in and around Chicago, Cook County and surrounding areas, including Flossmoor, Morton Grove, Wheeling, Northlake, and Cicero.

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