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Missed Bile Duct Stones Case Settled for $520,000

Last week we settled a case arising from care at the Cincinnati VA Hospital.  The relatively young veteran – he was only in his mid-40’s – was having gastrointestinal problems related to his gallbladder.  The VA determined he needed to have his gallbladder removed, a very reasonable call. However, the imaging done before the surgery showed stones in the common bile duct.  The common bile duct is essentially “downstream” from the gall bladder and it connects to other parts of the digestive system, including the pancreas.  Stones in the common bile duct can block the pancreas and lead to a very serious condition, pancreatitis, as well as liver problems.

In our client’s case, the young VA surgeon thought the stones were small and, therefore, “clinically insignificant.” Before the surgery, the veteran’s liver function tests were abnormal, a clear indication that, in fact, the stones were causing problems.  The surgeon simply ignored this information.  There were several ways the surgeon could have attempted to remove these stones, but she didn’t think any of them were needed.  After the surgery, the veteran continued to have problems which culminated in severe pancreatitis.  It could have killed him and at a couple of points during his long hospital stay (at a private hospital), he actually did code and required resuscitation.  He survived but was left with permanent problems, not the least of which was diabetes caused by the damage to his pancreas.

The surgeons we had review the case were flabbergasted.  If there were stones in the common bile duct they needed to be addressed.  There is no such thing as clinically insignificant stones, especially in the presence of abnormal liver function tests.  We were unequivocally told this was nota complex question.  It was basic surgery stuff.

At the administrative phase the VA flat out denied the claim – it made no offer - and it took its time making that plainly wrong decision.  We filed suit.  When it came time for the government to name its experts, it had no one who could defend the care of its doctor.  No one.  Finally, we then got the case resolved with the government agreeing to pay $520,000. 

That the healthcare providers caused a serious injury to this veteran was bad enough.  That the VA never made any effort to resolve this matter until relatively late in the process truly adds insult to the injury.  If the question of liability had been a close call, I could give the VA the benefit of the doubt.  However, other than something like amputating the wrong leg, the negligence issue here was about as clear as it gets in this business.  I have no idea why the VA persisted so long in thinking this case had no value whatsoever.  The impact of its decision and inertia was certainly not fair to this veteran. Had the case been resolved administratively – as it clearly should have been – the fee would have been 20% instead of 25% and the litigation costs would have been markedly lower.  In other words, this veteran could have netted more money if the matter had been settled early on.  

I am glad we were able to represent this veteran successfully.  We have been doing these cases for a long time now and we know what we are doing. Still, I think it is profoundly disappointing that the VA so often does not treat veterans fairly in the claim process and it frequently makes the process much harder than it needs to be. It takes good lawyers to apply the right kind of pressure to get these veterans an appropriate recovery.  Not to brag too much, but we are good lawyers. Very good, in fact.  


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