How much is a 7-inch steel clamp worth?
That's a question raised yesterday by Baltimore medical malpractice lawyer Marvin Ellin, in a claim filed with a state arbitration office on behalf of Linda D. Haines, a University of Maryland Medical Center patient in whose abdomen the scissors-like clamp was left after surgery.
Defendants include the University of Maryland Medical Systems Inc.; a gynecological surgeon, Dr. Julian P. Smith, and the surgical residents who assisted him, Dr. Brian D. Barnett and Dr. Elliott E. Cazes.
Dr. Smith and Dr. Barnett declined to comment on the case; Dr. Cazes could not be reached.
In the case filed with the Maryland Health Claims Arbitration Office, Mr. Ellin claims his 39-year-old Harford County client was referred to Dr. Smith for treatment of an ovarian cyst and agreed to surgery that he assured her was "simple" and "safe."
During the Aug. 24 operation under general anesthesia, surgical clamps were used to hold vessels cut away from the ovary and fallopian tubes.
The complaint alleges the surgical team was negligent in failing to take a proper instrument count to assure that all had been removed from Ms. Haines' abdomen before the incision was closed at the end of nearly four hours of surgery.
"Upon awakening from anesthesia, the patient immediately began suffering from excruciating pain," the complaint says, noting the clamp caused a blockage of bowel function and loops of bowel to become entwined in the instrument.
"As the patient's condition worsened, signs and symptoms compelled recognition of gastrointestinal compromise. As the residents came in to see the patient, she literally begged for relief from her pain and expressed fear that something was wrong."
An X-ray taken about noon on Aug. 28 turned up the cause of her distress, and she was wheeled back into surgery for removal of the clamp and some 50 inches of her small intestine, which averages 24 feet in adults.
The operation lasted more than five hours, and the prolonged procedure "terrified" the patient, the complaint alleges.
Ms. Haines also developed peritonitis and infection, leaving her at high risk for future gastrointestinal problems. She has a disfigurement and a scar from tubes that had to be inserted into her neck to administer treatment, the claim alleges.
She was discharged from the hospital Sept. 9, and has been recuperating at her Bel Air apartment, unable to return to her job as medical secretary to a cardiologist, the complaint charges.