ERCP Informed Consent Malpractice Lawsuit

Cain v. Gastro Associates

Doctor treating PatientThis medical malpractice lawsuit was filed against a gastroenterologist in Howard County on April 13, 2017. It is the 174th medical malpractice case filed in Maryland in 2017.

Summary of Plaintiff's Allegations

Plaintiff has a history of diverticulitis. She goes to defendant doctor, telling him that she has a history of an endoscopic retrograde cholangiography (ERCP) done a few years ago, and biliary sphincterotomy (cutting of the biliary sphincter during an ERCP). Defendant recommends an ERCP.

During the procedure, he finds the prior sphincterectopy to be narrowing, so he extends it by two centimeters. The woman is discharged home.

A few hours later, the woman goes to Greater Baltimore Washington Medical Center due to severe epigastric pain. She is discharged with post-ERCP pancreatitis that has evolved into necrotizing pancreatitis. She is hospitalized for much of the following year.

She files this claim alleging that the defendant never told her that the ERCP had a risk of pancreatitis that could lead to prolonged hospitalizations and disability.

Additional Comments
  • Miller & Zois' last verdict in an ERCP case was for $1.5 million in Baltimore County in 2016. Like this case, the question is whether the patient should have received an ERCP in the first place. You can see that verdict and other ERCP verdicts here.
  • There is a 5-10% risk of pancreatitis in ERCP cases.
  • Diverticulosis is a condition that most people develop as they get older. Diverticulosis is a pocket, a thin walled pocket in the wall of the colon. A good metaphor is someone driving on a tire for too long and soft spots form in the tire. Those spots are diverticula. It is wear and tear from a lifetime of the colon contracting and relaxing.
  • On the issue of informed consent, the question is whether a reasonably prudent person in the plaintiff's position would have decided not to undergo the operation or procedure.
  • The defendants are going to argue that a person with diverticulosis is at risk for great complications so a reasonable person would always go forward with the minimally invasive ERCP in spite of the known complication of pancreatitis. But diverticulosis rarely necessitates surgery. So this may be a tough argument unless this was a very serious case.
Jurisdiction
  • Howard County
Defendants
  • A gastroenterologist
  • Gastro Associates
Hospitals Where Patient was Treated
  • Greater Baltimore Medical Center
Negligence
  • Negligent recommendation of an ERCP to a patient at a high risk for developing post-ERCP pancreatitis
  • Negligent performing of an ERCP for diagnostic purposes
  • Negligently extending the sphincteromtomy by 6 to 8 centimeters
  • Failing to leave a prophylactic pancreatic stent
  • Performing the ERCP and sphincterotomy without informed consent
Specific Counts Pled
  • Negligence
  • Lack of Informed Consent
Plaintiff's Experts and Areas of Specialty
  • None at this time
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