$225K Verdict Illustrating Twisted Colon MalpracticeRobert Shively, Esq., Shively Law offices, Casper, WY
A volvulus is a rare condition that occurs when part of the colon twists around itself, causing a major bowel obstruction.
In this case, a woman with a history of reoccurring intestinal issues suffered an intense volvulus in the sigmoid region of her colon. The 75-year-old patient had been in and out of the hospital for months with diverticulosis, an inflammative condition where tiny pouches (diverticula) form on the wall of the colon.
The situation had finally devolved to the point where urgent surgery was needed to remove her entire sigmoid colon, including all areas covered in diverticula.
However, the doctor did not follow proper procedure. He made two incisions instead of one, he failed to remove the entire sigmoid colon, he completely botched the anastomosis, and then he sent his patient home leaking fecal matter into her abdomen.
Ten days later, as her symptoms worsened, she returned to the same doctor. He did not inspect the area where he botched the surgery. Instead, he misdiagnosed her as having a perforation in a completely unrelated area of her small intestines. The doctor then performed an unnecessary ileostomy in that area of the small intestines and sent her home again leaking infectious discharge into her abdominal cavity.
After seven more days of suffering, the patient visited a different doctor who quickly discovered what was wrong. He cleaned up the mess left by the Defendant, reversed his unnecessary ileostomy, removed the rest of the severely infected sigmoid colon, and performed a proper colonoscopy.
Robert Shively, Esq., needed jurors to understand why the first doctor was indisputably and egregiously liable for his client's pain, suffering, and disturbingly traumatic experience.
The following visual presentation helped Mr. Shivley return a $225K verdict for his client.
Exhibit A: Establishing the Normal Intestinal Anatomy
The first illustration introduces jurors to the gastrointestinal anatomy in a way that establishes prerequisite knowledge of the areas most important to the story.
We ghosted out excess details to focus jurors attention on the regions most impacted by the doctor's negligence. The two images on the right summarize the colon and small intestines.
Exhibit B: Introducing the Sigmoid Volvulus
Most jurors are probably not going to know what a sigmoid volvulus is, but a picture is worth a shocking number of words. Illustrating the constriction of the patient's colon covered in infected pouches helped jurors see just how twisted this rare condition was - while humanizing the brutal experience of the victim.
We call this a "visual anchor," because it anchors the most important element of the story with a powerfully unforgettable visual that jurors will remember throughout the case. This was the initial damage that the Defendant was supposed to remove.
Exhibit C: What did the Defendant do wrong?
After establishing what the initial injury entailed, we needed to show the negligence that followed. This surgery illustration walked jurors through the improper surgical procedure performed by the Defendant, according to his own report.
A major liability point in the case was that the Defendant should have only made one incision, removed the infected area, and reconnected the colon to the rectum. Instead, the Defendant made a separate incision 10 cm above the anastomosis, which significantly increased the risk of a leak.
Exhibit D: What Should the Defendant Have Done Right?
After establishing the improper surgery performed by the Defendant step-by-step, we compared the aftermath of the Defendant's botched surgery to the correct procedure.
The surgeon should have removed the entire sigmoid colon and diverticula. Instead, he left 15 cm of the sigmoid colon inside the patient. He also failed to complete the anastomosis correctly, which resulted in the colon leaking fecal matter into the patient's abdomen for weeks.
Exhibit E: What Damages Resulted from this Negligence?
Once we had established the negligent actions of the Defendant, it was time to anchor the jury's understanding of the horrific experience suffered by the Plaintiff, as a direct result of this botched surgery. Here we illustrate the post-op condition, along with a colorized CT scan of the Enterotomy Site.
The illustration helped emphasize the mess the Defendant caused inside the patient's abdomen. The Color Diagnostic helped ground this illustration in hard radiographic evidence that clearly showed leaking feculent fluid at the Enterotomy Site.
Exhibit F: How Did the Defendant Misdiagnose the Leak?
After completely botching his surgery and causing his patient enormous pain and suffering, he misdiagnosed the problem. For some reason, he diagnosed the leak as coming from a perforation in the ascending colon - in a completely separate area of the gastrointestinal anatomy.
In reality, as illustrated above, there was no perforation in the ascending colon and the leak was instead coming from the enterotomy site where he failed his first surgery. This misdiagnosis would lead to a second surgery that wasn't necessary.
Exhibit F: How Did the Defendant Make Things Worse?
Based on a wildly incorrect diagnosis, the Defendant then performed an unnecessary diverting ileostomy that did absolutely nothing to address the leaking fecal matter coming from her the first surgery site.
What the Defendant should have done was perform a proper colostomy with the full removal of the sigmoid colon, as illustrated above.
Exhibit G: How Was the Damage Ultimately Fixed?
The Plaintiff suffered through seven more days of nauseating pain before getting a second opinion. The new Doctor quickly identified the problem and immediately reversed the Defendant's second unnecessary ileostomy, removed the sigmoid colon, and cleaned the Defendant's abdomen of the mess created by the Defendant.