Man Who Lost his Intestines After Gallbladder Removal Awarded $49.25 Million

Case Overview

Case Name: Joseph Browning & Christine Browning v. Advocate Health & Hospitals Corporation and Dr. Daniel Resnick

Case Type: Medical Malpractice

Injury:

• Loss of intestines
• Small intestine transplant
• Stage 3 kidney disease (progressive)
• Loss of teeth
• Neuropathy (progressive) depression, anxiety, panic attacks, flashbacks, etc.

Plaintiff Attorney(s): Sharon L. Heath, Timothy W. Heath

Defense Attorney(s): David Burtker, Michael Compton, Robert Larsen

Case Outcome: Verdict-Plaintiff

Gross Award Amount: : $49,250,000.00

What Happened?

Joseph Browning, a 42-year-old foreperson machinist in Chicago, was experiencing pain in his side and back. His condition was so bad that on February 10, 2015, Browning went to the emergency room at Advocate Health & Hospitals Corporation’s Lutheran General facility. The next day at the hospital, Dr. Daniel Resnick diagnosed him with acute gallbladder inflammation. Dr. Resnick at Advocate performed laparoscopic gallbladder removal surgery on Browning that same day, February 11, 2015.

Known Risks for Mr. Browning

Dr. Resnick and a few other doctors were aware that Browning had undergone a gastric bypass procedure two years earlier. In this weight loss procedure, surgeons make changes to a patient’s stomach and small intestine to alter the way they absorb and digest food. Patients that have this gastric procedure face a life-long risk of developing an internal hernia of the intestines, known as a Petersen’s hernia.

The gallbladder removal surgery ordered for Browning also posed intestinal injury risks including bowel perforation.

Post-Surgery: Massive Infection Complications

The morning after his gallbladder removal, Joseph was not recovering as expected. His doctors decided to keep him in the hospital for one more day instead of discharging him. By the morning of February 13, the non-surgical doctors reported that Browning was in full-blown sepsis.

Sepsis is the body’s extreme response to an infection that most often starts in the gastrointestinal tract, urinary tract, lung, or skin. Considered a life-threatening medical emergency, sepsis can result in tissue damage, organ failure, and even death. The most severe stage of sepsis is septic shock. This medical condition happens when an infection in a person causes extremely low blood pressure and organ failure from sepsis.

Over the course of February 13 to February 24, Browning suffered severe sepsis, septic shock, and multi-organ system failure. On February 15, when Browning could no longer breathe on his own, the medical team inserted a tube to keep his trachea open (intubation) and connected him to a ventilator to keep him breathing.

Delays in Medical Action

Throughout Browning’s post-surgical deterioration, the medical records do not show that the gallbladder surgeon saw or examined his patient. Even though cultures revealed intestinal bacteria in Joseph’s blood and in his abdomen, no surgical intervention occurred. Despite a CT scan on February 20 showing Browning’s bowels were dilated—grounds to suspect a mechanical bowel obstruction and a perforation—the surgeon did not act. It took a second CT scan, performed on February 24, that revealed “slightly more” free air to get the doctor to take Browning into surgery.

In surgery, the medical team determined that the small bowel was dead. They also diagnosed Browning with a Petersen’s hernia. This type of hernia can cause pain and difficulties with intestinal function (intestinal ischemia) from a loss of blood flow. Peterson’s hernia can also lead to bowel necrosis. This is a late finding of decreased blood flow to the gastrointestinal tract that often comes along with a septic shock. In addition, an obstruction in the intestine is associated with this type of hernia. During the surgery on February 24, Dr. Resnick removed Browning’s small bowel.

On February 27, Dr. Resnick performed a second exploratory surgery. Dr. Resnick found that much of Browning’s sigmoid colon was now ischemic. Additionally, Dr. Resnick found that Browning had a bowel perforation in the sigmoid colon. The doctor found more ascites in the abdomen, which were infected with bacteria. On March 2, Dr. Resnick performed a third exploratory surgery and found exigent circumstances. This led doctors to remove Joseph’s small and large intestines and a portion of his stomach on March 2. Again, doctors found infected ascites.

Furthermore, Browning’s ascending, transverse, and descending colon were now ischemic. Dr. Resnick also found a small perforation in the transverse colon, which was leaking turbid fluid. The perforation in the transverse colon was in the same area as where doctors placed one of the trocars during the gallbladder removal surgery. On March 2, Dr. Resnick removed the remainder of Browning’s intestines except for approximately 6 inches of the small intestine and 12 inches of Browning’s large intestine near his rectum. As a result, Browning needed a small intestine transplant. He also suffered from stage 3 kidney disease from the long period of sepsis and from the medicines he took to prevent the rejection of his small bowel transplant. Browning also lost all his teeth and endures neuropathy (progressive) depression, anxiety, panic attacks, and flashbacks.

Allegations and Testimony

Browning and his wife sued the defendants for negligence. The plaintiffs contended that the surgeon’s failure to do a timely surgical exploration of his abdomen exacerbated his injury. In the plaintiffs’ view, immediately after the removal of his gall bladder, Joseph had all the signs and symptoms that indicated he likely was suffering from a bowel perforation or ischemic bowel. Yet, his doctors waited too long to do the CT scan with oral contrast. This resulted in the needed exploratory surgery not being performed until February 24. In addition, Browning maintained that when the first surgeon failed to recognize that Browning had an intra-abdominal infection on February 13, the 15 non-surgical doctors, who were aware of Joseph’s dire condition over the next 11 days, should have gotten a second surgical opinion.

Regarding the surgeon’s timely care and attention to Browning, Joseph’s wife and daughter testified that they remained in the medical intensive care unit (MICU) for almost the entire time from February 13 to February 24. Yet, they did not meet the surgeon until the night of the second surgery.

On the defendants’ side, they asserted that the surgeon had seen the patient daily on rounds with the surgical residents, even if his visits were not properly recorded in notes. The defense made these arguments even though the surgeon was not listed as present in the nurses’ or surgical residents’ notes. In addition, the head of the MICU testified that he intended to talk to the surgeon about the plaintiff’s condition. However, he did not see the surgeon in the MICU for the first three days that Browning spent there. Further, in his deposition, the head of the MICU also testified that he had reviewed the surgical residents’ notes. The MICU head determined that the surgeon had not returned to see Browning for two weeks.

The defense also dug in on the source or causes of Browning’s infection and injuries. First, the defendants contended that the source of Joseph’s initial infection was bile spillage, an infected gallbladder, or bile leakage. They made these claims even though the medical team did not take a culture of the bile or the gallbladder. They also made no effort to determine if there was any bile leakage after the gallbladder removal surgery.

Second, the defense argued that the intra-abdominal infection that Joseph suffered after the surgery did not directly cause any damage. Instead, the defendants maintained that a “low flow” state due to low blood pressure precipitated Browning’s ischemic bowel that leaked intestinal bacteria into his abdomen.

The defendants’ last main contention was that Joseph developed Petersen’s hernia separately from the initial infection and separately from the infection caused by the blood pressure problem. They said these conditions emerged unexpectedly, just before the exploratory surgery, with no prior telltale signs or symptoms. The defense claimed that his totally unexpected hernia was the reason he had to have his intestines and part of his stomach removed.

Who Won the Case?

After 14 days of evidence, a jury found the defendants were negligent and awarded Browning $49,250,000. The last offer plaintiffs rejected from defendants before trial was $5,000,000. The defendants did offer a high/low amount of $8,000,000/$2,000,000 right before the jury read the verdict. The defendants made this offer even though the jury had requested a calculator approximately an hour before the jury signaled that they had reached a verdict.

Key Takeaways

Browning v. Advocate Health & Hospitals Corporation and Dr. Daniel Resnick reminds medical malpractice lawyers that complicated medical cases require the right medical experts. Expert Institute offers a product called Expert Search that helps lawyers identify the expert medical specialists they’ll need to prevail based on the medical issues in the lawsuit. In this case, Expert Institute provided the plaintiffs’ counsel with an expert specializing in physical medicine and rehabilitation which proved crucial to the outcome.