Case Archive

Baby Fractures Skull During Delivery

At 22:00 it is reported that dilation was 4.0, effacement 50 and station -2. At 23:01 contraction frequency was 3 and contraction duration 60-90. At 23:53 contraction frequency was 3-4 and duration 40-100. At 23:55 the patient requested an epidural. At 00:08 the patient was positioned on the side of the bed for the epidural […]

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Bowel Perforation During D & C

During a tubal ligation, patient sustained bowel perforation on December 10. Despite symptoms (abdominal pain, distention) that began the day after the procedure, the perforation was not diagnosed until December 13. By that time, patient had developed severe peritonitis, sepsis, pneumonia, and malnutrition. She subsequently underwent emergency repair on December 16, placement of a central […]

C. difficile Cases Worth Pursuing

1- Inappropriate antibiotic use can cause this condition which can be fatal. 2- Use of anti-peristaltic Rx such as Imodium or Lomotil is contraindicated in C. diff and can lead to toxic megacolon and death or need for total colectomy. 3- Failure to treat long enough or to discontinue offending antibiotic therapy are also problematic. […]

Endarterectomy with Nerve Transection

Issue: Is it a departure from the standard of surgical care to completely transect the hypoglossal nerve during endarterectomy. Operative report indicates that it was inadvertently divided along with a very high facial vein and thus its distribution was described as aberrant. Primary repair was accomplished intraoperatively. MEDQUEST EXPERT RESPONSES: It is a departure. This […]

Drop Following Hernia Surgery

50 y/o female admitted for abdominal surgery for excision of abd wall hernia following uterine malignancy. The operative procedure lasted more than 9 hours with the majority of the procedure in extreme Trendelenburg position. Patient complained of leg pain immediately on arrival to PACU. The discharge note makes no mention of any complaints. Patient returned […]