Word Catheter [Bartholin's Cyst]
Case #199
A 30-year-old woman developed pain and swelling near the vaginal introitus.
She went to see her OBGYN, Dr. L.
Dr. L diagnosed her with a Bartholin’s gland abscess.
He drained the abscess and placed a Word catheter on July 9, 2008.
After the Word catheter was removed, the patient continued to have episodes of pain and drainage at the site, although not as bad as the original abscess.
Over the next 4 years, Dr. L repeatedly gave her antibiotics whenever her symptoms flared.
The degree of swelling on exam was never enough to justify a repeat procedure.
She last saw Dr. L on April 20, 2012.
The patient decided to see a different OBGYN about her recurrent symptoms.
She saw Dr. K on November 7, 2013, and he recommended a marsupialization procedure.
The operation was done on December 11, 2013.
During the surgery, a retained foreign body was found in the cyst cavity.
Dr. K identified it as the tip of a Word catheter.
After removing the foreign body and having a marsupialization procedure, her symptoms improved significantly.
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The patient filed a lawsuit against Dr. L.
The expert witness opinion is shown here:
This state has a standard 2-year statute of limitations, and in some cases allows 3 years.
The plaintiff alleged that Dr. L was responsible for the patient’s care until November 7, 2013, when the patient first saw the new OBGYN, Dr. K.
The plaintiff was given a 90-day extension and filed the lawsuit on January 20, 2016.
The defense argued that the statute of limitations should be calculated based on the patient’s last visit with Dr. L on April 20, 2012.
This would mean that the lawsuit was filed after the statute of limitations expired.
The judge agreed with the defense and the lawsuit was dismissed.
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MedMalReviewer Analysis:
The expert witness should have gone into more depth about how the catheter was removed. It’s not clear if the OBGYN removed it, if there was a product malfunction, or if the patient may have removed it herself. It just doesn’t make any sense why a piece of the Word catheter was left behind. I think there is a chance the patient may have cut it herself to remove it and accidentally left the tip behind. I’ve never heard of this happening with a Word catheter before, but I’ve seen more than one case in which a patient cuts their Foley catheter and urology has to retrieve the catheter tip from the bladder.
Dr. L never had to defend his medical decisions because the case was dismissed on legal grounds. However, the fact that he mentioned doing a repeat operation on her after multiple recurrences, but never did so, would have been difficult to defend.
Some states determine the statute of limitations based on when a doctor’s alleged negligence is discovered, not when it actually occurred. Apparently this state does not. It does strike me as a bit unfair to patients who are truly harmed by negligent physicians and don’t realize it for several years.
The expert left too many basic grammar errors and typos in his opinion to take him seriously. In the very first line he tries to claim he did a thorough review, but accidently writes that he did a “through” review. His review wasn’t thorough enough to address the obvious elephant in the room, which is how the catheter was removed. Numbers are randomly injected in places that don’t make any sense. I’ve never seen a Word catheter written as a “Ward” catheter but he does this throughout (maybe this is a regional variation). Limited typos are excusable, but overall the expert comes across as sloppy and inattentive. Any informed reader will question the validity of his opinion. The plaintiff’s attorney apparently was not any better given he didn’t bother to proofread the expert’s opinion, and took on a case with very limited damages that was outside of the statute of limitations.
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Thats not expert witness testimony. It says Certificate of Merit at the top. At least where I practice, the person writing it doesn't need to be in a related specialty and they're typically retired physicians making a few extra dollars.
That is weird, typically we place them in ED and tell patients to f/u with pcp for removal or they sometimes fall out on their own, never heard of one breaking off. Have to admit, Ive placed alot of them but have yet to remove one.