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Hospital Hit With $5M Verdict After Lap Chole Patient's Post-Discharge Death

Woman, 49, died after she was discharged the same day she underwent an emergency gallbladder removal at a Philadelphia hospital.

Published: July 31, 2017

In an apparent case of premature hospital discharge, a jury awarded $5 million to the family of a 49-year-old woman who died after she was discharged the same day she underwent an emergency laparoscopic cholecystectomy at a Philadelphia hospital.

Janette Lambert went to Albert Einstein Medical Center emergency room on July 21, 2014, complaining of severe abdominal and back pain along with nausea and vomiting. She was admitted and underwent a laparoscopic cholecystectomy the next day.

A physical therapist who saw Ms. Lambert following her procedure noted in her chart that she should remain hospitalized for 3 more days, court records show. But the hospital discharged Ms. Lambert the day of surgery — even though she was complaining of severe abdominal pain.

Ms. Lambert returned to Einstein 2 days after discharge complaining of unbearable pain. Doctors discovered she had a bile leak. They placed a drain, but the symptoms continued. She coded on July 26, was resuscitated, but died a day later after complete organ failure.

Although the hospital had discharge protocols in place, none of the members of her care team could remember if the guidelines were followed or understand their individual responsibilities, according to court records. "Worse yet, either the staff were unaware of Ms. Lambert's alarming condition revealed during physical therapy or, alternatively, they just disregarded it altogether," court records say.

The lawyer for Ms. Lambert's surviving relatives alleged that the case of premature hospital discharge came down to a miscommunication between the doctors and the residents. The lawyer argued that the surgeon who performed Ms. Lambert's procedure and the team of surgical residents who cared for her during recovery failed to ensure she was stable enough for discharge and sent her home prematurely with a developing bile leak. The lawyer further alleged that the surgeon relied on misinformation about Ms. Lambert's condition provided by the surgical residents and did not review the physical therapist's note about extending Ms. Lambert's stay.

Court documents filed by the defense say that Ms. Lambert's pain was adequately controlled, she was tolerating food and there was no evidence of a bile leak. The documents also note that her vital signs were stable and her pain level was appropriate for the surgery she had undergone, so she was deemed stable for discharge.

The defense team says Ms. Lambert's treatment was appropriate and consistent with the standard of care. They claim a bile leak is a recognized complication of cholecystectomy and the ERCP performed to repair the leak resulted in severe pancreatitis that caused her body's organs to shut down. Recognizing the bile leak earlier would not have prevented the need for ERCP and keeping Ms. Lambert hospitalized longer would therefore not have prevented her death, according to the defense's documents.

A spokesperson for Albert Einstein Medical Center and Daniel Ryan, the hospital's attorney, did not respond to requests for comment.

Lane Jubb, the attorney for Ms. Lambert's surviving family members, says the case serves as a warning to surgical professionals about the importance of clear communication among the entire patient care team. "Attending physicians also have to make sure residents are accountable if they're on the front lines of care," says Mr. Jubb. "They have to be held to the same standards as the attending surgeon."

Daniel Cook

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