"Horrific" consequences of Kaiser Permanente's failure to properly monitor bladder patient during and after surgery

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Patient Blames Kaiser for 'Horrific Events'
By BARBARA WALLACE
Courthouse News Service
May 08, 2013

DENVER (CN) - Two Kaiser doctors and a nurse practitioner overlooked an important lab test for a patient about to undergo bladder surgery, and both doctors made mistakes during the surgery, resulting in a "cascade of horrifying complications," the patient says in a complaint filed in Denver District Court.

Urologist Mina Shabnam Lee diagnosed 71-year-old Josephine Jansen with a mass in her bladder in April of 2011 and recommended a surgical procedure called a "bladder transurethral resection neoplasm," according to Jansen's complaint.

A nurse practitioner, Andrea Anderson, performed a pre-operative examination and Dr. Lee ordered lab work, the complaint states. Nonetheless, neither they nor the anesthesiologist, Thomas Arthur Gettelman, ordered a test of Jansen's sodium level, according to the complaint. "Either defendant Anderson or defendant Lee or defendant Gettelman could have easily ordered a simple blood test which would have included a panel of electrolytes such as sodium. The ordering of a sodium lab value is extremely easy, and non harmful to the patient, and would only take a matter of minutes to obtain. However, the priorities of each defendant were such as not to obtain this test. Moreover at least one of the drugs that the plaintiff was taking, Hydrochlorothiazide, (HCTZ) is a diuretic and has the effect of lowering some electrolyte lab values," Jansen says in her complaint.

"During the surgical procedure performed by defendant Lee, various and serious complications occurred," the complaint continues, including a ruptured bladder, and aspiration of stomach contents into Jansen's airway because Dr. Gettelman was "negligent in the performance of his duties as an anesthesiologist during the operative period," according to the complaint.

The complaint states that Dr. Lee, failed "to adequately consider the effects of fluid absorption as a result of the surgical misadventure."

"Defendant's superficial approach to this patient - particularly in having no understanding of her sodium prior to surgery - set into motion the cascade of horrifying complications which followed the surgery. And her operative and post operative mismanagement (especially in not ordering serum sodium immediately post surgery) caused further and increased harm to plaintiff," the complaint states.

"Following the surgery the plaintiff sustained severe and irreparable injury. She went into shock caused by abnormal and an almost deadly level of sodium, plaintiff's bladder was ruptured during the surgery and shortly following the surgery it was determined that plaintiff had developed severe hyponatremia which was complicated by acute cardiac decompression due to the stress induced cardiomyopathy, respiratory failure, renal failure requiring dialysis, prolonged ventilation, and significant neurological injuries. This cascade of horrific events including multi organ failure, were caused by the negligence of the defendants," Jansen's complaint says.

"Much of her damages are permanent in nature and her life has been forever changed," the complaint states. "The plaintiff has incurred substantial economic losses including the loss of her career."

Plaintiff is represented by John Astuno, Jr. of Denver.