In 2001, a urologist performed a bladder suspension surgery to address incontinence. During the surgery, the urologist placed titanium anchors into the patient’s pelvic bone using an anchor driver, which is a metallic device. In 2015, part of the anchor driver was found inside the plaintiff’s body near her pelvic bone and was removed. In 2016, the plaintiff filed a medical malpractice complaint against the health care facility and multiple physicians, including the urologist who performed the 2001 procedure.
In her complaint, the patient alleged that she went to the facility in January 2001 with a symptomatic cystocele and some stress incontinence. She was seen by a urologist, who performed surgery on her in the form of an endoscopic bladder suspension.
What Happened in Her Procedure
During the procedure, the urologist used anchors to support the suspension. The patient asserted that after the bladder suspension surgery, she experienced unusual pain in her pelvic area. She alleged that she notified the urologist of her continuing pain and was told there was nothing wrong. Specifically, she alleged that she returned to the urology office twice in 2004, once in 2009, and once in 2012, complaining of continued pain that she associated with the surgical procedure in 2001.
It was asserted that diagnostic imaging was performed at all four visits and each time she was informed that the imaging showed nothing that could account for her painful symptoms. However, according to the patient, x-rays from 2009 and 2012 clearly showed a foreign body in her pelvis.
It was further alleged that she underwent a second surgical procedure with the same urologist in 2012 in the form of a bladder instillation and transvaginal obturator tape procedure. When consulting with the urologist about the second surgery, the plaintiff complained that she felt as if something were poking into her in her pelvic region. The plaintiff asserted that the urologist dismissed her concerns.
What Else Happened
In 2014, she went to an emergency room with pain. During the visit to the ER the patient underwent a computed tomography scan of her abdomen and pelvis. A radiologist read the scan and noted a 2.2-cm metallic object.
She alleged that when she returned to the health care facility in 2015 reporting pain, she was diagnosed with pubic cellulitis overlaying retained public symphysis hardware. She stated she was informed that she might have an anchor in her pubic bone that needed to be removed and was transferred to a tertiary hospital. Another x-ray report noted the anchor device from her surgery may represent a piece of broken hardware.
The woman subsequently underwent surgery at the hospital to remove the object, which she asserted proved to be the instrument part that was used to place anchors for the bladder surgery and was abandoned by the defendant urologist and left within her.
What Did the Courts Think
Given that there was a span of fourteen years between the original surgical procedure and the 2015 procedure when the metallic object was removed, the patient purported that the continuing course of treatment doctrine applied and cited the several times in between 2001 and 2015 that she returned to the defendant reporting pelvic pain.
What was discovered at trial, however, was that in 2004, the plaintiff moved out of state, never returning to the health care facility or the original urologist until 2009 and 2012. When the plaintiff did return in 2009 and 2012, she returned for complaints unrelated to her previous pelvic pain. Therefore, the court held that the plaintiff’s course of treatment ended in 2004, and therefore the doctrine did not apply.
Not all states have applied the continuing course of treatment doctrine, and where it has been applied, there are many nuances and variations. Providers interested in knowing the rule in their own jurisdiction should consult with the appropriate legal authority in their facility or organization.
It is unfortunate that there is this back and forth between the patient and the urologist. We pride ourselves on never having that issue with patients after surgeries. Having a quality urologist can help in any of the issues that may arise. If you need a quality urologist pick up the phone and call Z Urology, with offices in South Florida. Call today!
We provide state-of-the-art urologic care in the South Florida area with a focus on both male and female urology. Our practice specializes in all urologic procedures, specifically, minimally invasive methods. Our three locations to choose from are located in Fort Lauderdale, Coral Springs and Pompano Beach.
We at “Z” specialize in bladder issues, erectile dysfunction (ED), prostate issues, urinary incontinence, sexual dysfunction, stone disease, BPH, male infertility, pyeloplasty, Peyronie’s disease, and ureteral reimplantation.