A medical malpractice case against two doctors involved in a woman's 2006 surgery that allegedly left her with a punctured bowel got under way Tuesday in Madison County.
While attorney for plaintiff Penny Keller, Gregory Shevlin, likened the conduct of two doctors who allegedly tore his client's intestines during surgery to a driver broadsiding another car, his defense counterparts told jurors that no evidence showed their clients had been negligent at all.
Keller is suing Dr. James Dalla Riva, his practice, Dr. Thomas Hulsen and the owners of Anderson Hospital in Maryville for at least $50,000 in damages and other relief.
Keller claims Dalla Riva, an obstetrician-gynecologist, negligently tore a hole in her small intestine when he performed a laparoscopy to remove an ovarian cyst in 2006.
Keller claims that she then developed an infection after Dalla Riva discharged her without allegedly finding the bowel injury.
Hulsen allegedly failed to properly diagnose and treat the puncture before it was discovered about two days after the surgery in the Anderson Hospital's emergency room.
Following surgery to repair the hole, Keller claims she suffers from Irritable Bowel Syndrome (IBS) and other problems related to the surgery.
In his opening statement, Shevlin pointed to what he told jurors was the known risk involved in the surgery and how the doctors should have known to minimize it.
"You will hear that a bowel perforation, like what happened to Penny, is a known complication," Shevlin said. He then compared it to driving through a green traffic light knowing a person could be broadsided by another driver.
"Surgeons are taught to guard against the known complications," Shevlin added.
He told jurors Dalla Riva should have known to perform an "open" surgery as opposed to the type he chose because Keller had a history of heavy scar tissue inside her abdomen.
He cited a 2002 surgery on Keller that Dalla Riva performed where he switched from the laparoscopy to another type of surgery in the middle of the procedure.
He told jurors Dalla Riva and Hulsen had failed to note signs of infection in his client even after nurses and other staff at Anderson Hospital reported them.
He described one of those symptoms as green drainage "spewing out," of Keller's abdomen.
Shevlin detailed the impact Keller's life from the bowel injury: the removal of 14 inches of her small intestine and the IBS.
IBS is a condition that includes constipation, sudden diarrhea and other symptoms.
"None of this stuff is pleasant to talk about," Shevlin said. "It's even less pleasant to live with."
Paul Lynch, Dalla Riva's attorney acknowledged the bowel injury in his opening statement.
However, he told jurors, an injury did not prove that his client was at fault.
"Keep an open mind until you hear all the evidence in the case," Lynch told jurors.
He disputed whether Dalla Riva's decision to use the type of surgery that he did was to blame for the incident.
Lynch told jurors that even the plaintiff's expert agreed that bowel injuries during surgeries happen without a doctor doing anything wrong.
Lynch touched briefly on Keller's claims about the effects of the surgery.
"You've got many feet of small bowel," Lynch said, "14 inches isn't going to make a difference in function."
He cited tests Keller has undergone since the surgery that did not show anything wrong with her intestine's function.
Michael Pitzer, representing Hulsen, disputed Shevlin's view of the examinations and process by which Keller's injury came to light.
"I say to you now there is nothing in the medical record that uses the word 'spewing,'" Pitzer said.
He argued experts would testify that his client followed the appropriate routes to diagnose the bowel perforation and that to find it in 48 hours was a good diagnosis time.
"If you ask yourselves what Dr. Hulsen did wrong, I think you'll find that he did nothing wrong," Pitzer said.
Following opening statements, the plaintiff's case opened with Dalla Riva called to the stand.
The trial will continue Wednesday.
Jury selection took up the entirety of the trial's first day.
Gregory Shevlin represents Keller.
Paul Lynch represents Dalla Riva.
Michael Pitzer represents Hulsen.
The hospital's owner, Southwest Illinois Health Facilities Inc. is represented by Jonathan Ries. Southwest Illinois Health is named in the suit as the doctors' respondent superior.
The case is Madison case number 08-L-203.