Two common types of Ohio medical malpractice claims arise out of delays in treating aortic abdominal aneurysms (AAAs): failure to perform a AAA repair in the face of a growing aneurysm and failure to emergently diagnose and treat a symptomatic AAA. AAAs are part of a broader category of thoracic aortic disease (TAD), which also includes aortic dissections. The incidence of TAD has tripled in the last two decades, as the population ages. Traditionally, the treatment of choice has been open surgery. But the risk associated with open repair increases with age.
In recent years, attention has been given to endovascular solutions to TAD. Contrasted with open repair, where the aorta is accessed via a large incision, endovascular repair is less invasive as the vein is accessed internally using a catheter threaded through the venous system. You can read more about this here: http://circ.ahajournals.org/content/121/25/2780.full.pdf.
At Mishkind Kulwicki Law, we have investigated two types of medical malpractice claims involving AAA repair. First, older patients are often screened for AAAs using serial ultrasounds. Once an aneurysm reaches operable size, the patient should be advised about repair. Failure to screen resulting in delayed diagnosis, or delay in treatment when the screening ultrasound shows that an aneurysm has reached operable size, are potentially actionable. Likewise, operating before an aneurysm reaches operable size, based on faulty measurements or overly aggressive management, may be grounds for a lawsuit.
The second type of case arises out of delays in diagnosis when a patient develops symptoms of an AAA, a rupture or dissection. TAD, including a large AAA, may occasionally be accompanied with symptoms such as pulsating sensations in the abdomen and/or pain in the chest, lower back or scrotum. This may be an indication for surgery. Upon rupture or dissection, symptoms intensify with the onset of excruciating pain and hypotension. Rapid diagnosis and repair offers the only chance of survival.
Another consideration for AAA cases is that complication rates, including mortality, are reduced when surgery is performed at a high volume center. Thus, as part of the informed consent process for non-emergency cases, the surgeon must disclose to the patient that he/she has limited experience with the repair procedure when that is the case.
I understand your frustration and you raise a number of very good questions. The problems you experienced may be a known and recognized complication of AAA surgery. Your medical records and your prior medical history would need to be reviewed to determine if, in fact, this complication was a well-recognized and potentially unavoidable complication of your surgery. It is hard to say without further review and i would suggest that you contact a local attorney in your area to review your records. if you live in Ohio, we will be happy to talk to you. The bigger problem is balancing the fact that your aneurysm was huge and needed emergency surgery so it will be difficult to prove that delaying the surgery would have been reasonable due to the potential of a rupture and death. Further, the issue of informed consent is a difficult one to prevail on in a medical claim where the benefit of having the surgery which is lifesaving would be difficult to prove after the fact that you would have declined the surgery if you were told that the complication in terms of blood flow that you experienced could happen. In other words, I understand your point of view about wanting to ask appropriate questions to make an informed decision, but at the end of the day, I am not sure you would be able to establish that a reasonable person in your position with an emergency surgery to save your life would have elected not to proceed. If you live in Ohio, please know that you only have a 1-year statute of limitations to take legal action, so you need to consult directly with an attorney before your time expires. It would appear that in Ohio your statute of limitations may expire on or shortly after November 7 when you discovered the injury but please consult with an attorney as this blog does not substitute for securing a legal opinion from an attorney based upon all of the facts. Good luck.
I’m am a 59 year old male , on Oct 19th last year I went to the local ER with severe back pain I was given a Cat Scan and was told I had a AAA at 7.2 and that it was getting ready to burst , I did not understand what it was but they told me If it bursts I could die in one minute they rushed me to RI hospital I met a Dr at the OR entrance He introduced himself then I asked him what he was going to do because I did not know anything about this , he told me he was going to do what is called an open repair and its been tried and proven for over 70 years and he felt he needed to do it wright away , I wanted to see my wife and son but he told me there was no time , I felt ok enough to see my family just very uncomfortable , I bought in and let them do there thing, I did not see the surgin until Nov 7 when he removed the staples he told me everything looked great and he will see me in a year. I left his office ,when I had sex I for the first time no problem the a few days later again no problem a week later started out great then just a clunk when I orgasm no ejaculation and nothing since I talked to my Dr he said not worry take a stronger dose of Viagra ,that did not work and I could not get an erection , I could not get into see my urologist ,so I called the surgin who did the aaa and his office staff told me oh yes that is an outcome of the surgery would you like to see the Dr I said yes , when I did see the Dr he told me he never had a complaint before then he said oh yes someone else your age had this problem I told him this needs to be fixed he told me he will ask another rDr to look into it and that dr will call me , I asked him why didn’t he tell me about this when we met at the entrance to the Or he told me I thought you wanted to live , I told him I would raver have died then to live like this , I now wet myself and don’t know it My bladder dose not empty completely and I wet the bed ?? This Dr did not give me any choice he did not educate me to what my options where at the OR door or when he removed the Staples . I feel by keeping me from my family we could not ask the appropriate questions to make an informed decision. I do not know how to handle this legally. Thanks for listening.