Post Surgery Complication Turns Fatal

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Diane Stewart, 70, finally decided to have the knee replacement surgery her family and friends had urged her to have for years. She had suffered from severe arthritis since a car accident 40 years ago had crushed her knees. Now, unable to walk, she gave in to her family’s demands to have the surgery. Her family had made sure that the surgery would be performed at a hospital that enjoyed a very good reputation- Stanford University Medical Center in Palo Alto. The knee replacement surgery was performed by Stanford University Professor Dr. Stuart Goodman. As she prepared for surgery on March 30, 2007, she seemed in capable hands.
After the surgery, she began to complain of excruciating pain in her abdomen. Her family asked to speak with her doctor, but it was the weekend and her doctor was unavailable. By the time a doctor examined her, it was too late. She had gone into shock and was rushed into intensive care where she died due to a bowel obstruction. If the bowel obstruction had been detected when she began complaining of pain, her doctors could have resolved the issue by inserting a nasogastric tube to relieve pressure on the bowel or by surgery. If left untreated, the condition is very dangerous. The patient can develop peritonitis, go into septic shock, and die. This is precisely what happened to Diane Stewart.
Her family has filed a medical malpractice lawsuit against the hospital as well as her surgeon. As part of the investigation into Stewart’s death, a nurse told an investigator from the Department of Health Services that she had called two doctors asking to insert a nasogastric tube but both denied her request. She also told the investigator she asked one of the doctors to visit Stewart, but he declined to do so. According to the lawsuit, Stewart showed further signs of a bowel obstruction. She was experiencing decreased urine output, nausea, vomiting, elevated heart rate, and a sudden drop in blood pressure. On Monday morning, she was disoriented and breathing rapidly, and nurses could not find her pulse, records show. She was rushed to the emergency room. She died due to a bowel obstruction, according to hospital records.
According to a story in the San Francisco Chronicle, state health investigators found that the hospital destroyed part of Stewart’s medical records. “In 2008, investigators from the state Department of Public Health found that “relevant” portions of Diane Stewart’s computer file had been deleted after her death and that a supervisor instructed a nurse to make postmortem “late entries” to describe her care. In a written statement, the hospital said that only temporary notes that were never intended to become part of Diane Stewart’s permanent record had been discarded. Soon after that, her son (a physician) asked to review her medical records. Stanford officials resisted. Meanwhile, after her death, someone deleted some of her records from the hospital computer, the state health department later found. Then, a week after she died, nurses made a series of late entries to her file. The late entries described her condition in the hours before she went to the intensive-care unit. In a 2008 statement of deficiencies, the health department said Stanford Hospital had “failed to permanently record relevant information” about the patient, as required by state law. In the lawsuit, Stewart’s family says that both the destruction of the records and the late entries to the file were part of an effort to cover up the negligence and mistakes that led to her death.”
Diane Stewart’s death is a tragedy. According to her family, the death was a direct result of her physicians’ failure to diagnose a bowel obstruction and treat it in a timely fashion.

Kevin Dugan
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