Having taken to trial fatal small bowel obstruction cases in Maryland courts, the lawyers at Clark and Steinhorn, LLC are aware of the difficulties associated with proving both the negligence and the causation elements of such cases.
Abdominal pain is the preeminent cause for emergency department presentation and on most occasions is the result of some innocuous problem. The difficulty occurs when the problem is serious in nature as the extent of the symptoms is not a good indicator.
Basic techniques of examination such as auscultation, palpation, plain radiographic films and complete blood count, are standard operating procedure in emergency rooms but are of very limited value particularly for small bowel obstruction diagnosis.
The CT scan has enormous value in SBO diagnosis in conjunction with likelihood ratios. Prior history of abdominal surgery ( or in some cases abdominal stab wounds) also enhances the probability of SBO.
The problem with proving the elements of medical negligence are that best diagnostic practices aren't invariably followed and that delays in operative management are rampant. The excuse that diagnostic difficulties caused delay often results in assertions that surgery had a less than 50% chance of survivability in particular for elderly patients.
Such fatal SBO cases need to be seen as process failures from emergency room arrival through unsucessful attempts at surgical intervention. Then jurors can ascribe responsibility correctly.
