After suffering numerous complications from her family physician, a patient decided to sue with allegations of malpractice. The first stage of her suit related to her excessive drug prescriptions of Effexor and Lithium, which caused her to develop Lithium toxicity and alterations in her mental health and development. These conditions went undiagnosed by her doctors, and while she was hospitalized the patient suffered a fall that caused a sternal wire in her chest to break. Consequently, the patient remained in extensive pain, and required a surgical repair where the staff allegedly failed to remove a piece of sponge that had been left over from the Vacuum Assisted Closure, or VAC, and remained embedded in the patient’s wound. She then required surgical removal of the retained sponge, as well as additional surgeries to treat her for complications associated with the wound’s infection. The patient remained in a weakened state at the time of trial, where she claimed that a series of inept medical decisions had led to costly medical bills and months of rehabilitation.
Question(s) For Expert Witness
1. Is it a breach in the standard of care to leave a sponge component behind during a VAC repair?
2. What is the likelihood of contracting a post surgical infection from an open sternotomy given that products of wound care were left behind?
Expert Witness Response E-003939
It seems like there may be some details missing from this case. First of all, I do not believe that a fall, no matter how severe, would be the sole reason a sternal wire would break - they actually break all the time, and typically do not require removal. If they do, the removal can be done through a small incision, and it is difficult to catch the kind of sternal infection described by the case from such a procedure. I would need to review the medical records of the patient to sully discuss why a doctor would feel it necessary to remove a sternal wire, and how it would have resulted in infection. The sponge issue is also curious; a wound VAC typically uses an open dress procedure, and any remaining sponge would be plainly visible in the open wound. It’s not like a situation where a gauze sponge was left in a sewn-up incision. I would need to know more of these details in order to fully comment on the case.
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