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Maria Hoshal recalls the pain her mother, Carol Ann Doyle, suffered after laparoscopic surgery to remove her gall bladder. Her mother died seven days after the surgery.
Sunday, Sept. 19, 2010 | 2 a.m.
Do No Harm: Maria Hoshal
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On Nov. 6, 2006, Maria Hoshal's mother, Carol Ann Doyle, had her gall bladder removed at a local hospital. Doyle died eight days later from sepsis.
Do No Harm: Hospital Care in Las Vegas, Part 3
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Among Carol Ann Doyle's last words was an anguished cry that "something was backwards" inside her.
Dr. Gregg Ripplinger had warned Doyle that she would be in some pain after laparoscopic surgery to remove her gall bladder.
But soon after the surgery, which took place on Nov. 6, 2006, at St. Rose Dominican Hospital — Rose de Lima Campus, it was obvious to Doyle and her family that something was wrong. The active 70-year-old, who stayed busy following the lives of her 14 grandchildren and the Las Vegas Wranglers hockey team, should have been up and walking after the procedure. Instead, she was doubled over on the couch in the fetal position, according to her daughter, Maria Hoshal.
On Nov. 7, Doyle returned to the St. Rose emergency room, according to a lawsuit her family has filed, where she saw Dr. Lyn Knoblock, Ripplinger's partner. Knoblock dismissed Doyle's complaints, Hoshal said. "She flat out told her, 'She's not having any pain. You're not really feeling any pain, dear.' "
Knoblock prescribed more pain medication, though. And the family dutifully gave Doyle her antibiotics and painkillers, as instructed. But nothing worked.
Leann Sanders, attorney for St. Rose, disagreed with Hoshal's depiction of the hospital visit. She said in an e-mail that the hospital provided appropriate treatment to Doyle — ordering diagnostic studies and lab work and arranging to have her admitted.
"We believe that the physician acted well within the applicable standard of care in the treatment provided to Mrs. Doyle," Sanders said.
Knoblock and Ripplinger did not return requests for comment for this story.
Concerned, the family called Ripplinger's office. On the fourth day after the surgery, the family said Ripplinger examined Doyle and told them that her pain was normal.
Back home, Doyle remained in bed. The short walk to the bathroom took about an hour, Hoshal said.
Within two days, Doyle could no longer move. She told her family that "something was backwards" in her gut.
According to court records, Doyle's family called the doctor's office again and was instructed to give her more Lortab, a common narcotic painkiller. Doyle began hallucinating.
The next day, Sunday, Nov. 12, Doyle couldn't speak and was taken by ambulance to Spring Valley Hospital. A CT scan revealed her insides were filling with bile, a yellow-green fluid produced by the liver that helps digest fat.
"She's the sickest woman in the hospital right now and that's saying a lot," a doctor warned the family.
Doyle was rushed into surgery, where the doctor cleaned out the bile. The family claims they were told that either a misplaced or wrong-size clamp was used during her gall bladder surgery. As a result, the cystic duct had leaked bile into her abdomen. Doyle was poisoning herself. She was septic.
Doctors at Spring Valley didn't explain how the problem with the clamp had occurred, and Hoshal said the family was too stunned to probe.
They went home late that night, only to be called back to the hospital at 3 a.m. to say their final goodbyes to Doyle.
Hoshal said she had urged her mom to fight for her life. But after seeing all the suffering, Hoshal said her final words to Doyle were that it was OK to let go, that she loved her and would always love her.
An autopsy determined Doyle's death was accidental, caused by peritonitis — an infection of the membrane that lines the inner abdominal wall — resulting from a leak at the laparoscopic cholecystectomy site.
Hoshal said that at the time she thought her mother's death was a freak accident.
More than a year later, Hoshal met a nurse at a Christmas party and told her about her mother.
"Death is not a normal conclusion for laparoscopic gall bladder surgery," the nurse said. "The amount of pain she was in, somebody should have run a test."
Until then, it hadn't occurred to Hoshal that her mother's death might have been preventable.
In early 2008, Hoshal and her sister pulled the records from St. Rose and Spring Valley, and found the doctor's note about the clamp either coming loose or being improperly placed. She was stunned.
The light bulb went on, she said. "Somebody made a mistake and didn't catch it or didn't fix it and should have."
Doyle had raised her children to respect authority and the abilities and opinions of experts. Hoshal said she regrets accepting the opinions of Ripplinger, Knoblock and others at the St. Rose emergency room with "blind faith."
"You put your faith in your doctor, and to have your faith abused to the point where death is the result is very disheartening," Hoshal said. "We did what we thought we were supposed to do."
The family is suing Ripplinger, Knoblock and St. Rose, hoping that their mother's death can bring changes that will protect other patients.
Hoshal doesn't want Ripplinger to lose his license, but does want him to pay more attention and take more time with patients.
"It's a frightening thought that it may not have even penetrated his consciousness that there was a mistake made that was correctable and should have been corrected," she said. "He's got people's lives literally in his hands on a daily basis. That's a huge responsibility and you need to be able to be up on that responsibility and take ownership of that."
My heart felt condolences to the family.
I too, learned that it is ok, to question doctors.
when will the legislature finally dismantle the medical board???
http://www.medboard.nv.gov/New_MemStaff....
Doctors are human and makes mistakes just like we all do on our jobs. Web MD is a good source to learn about your issue if you have time prior, or call a family member with computer access and ask them to look it up and learn everything about your medical issue.
Ask questions, be alert, or have someone in your family there to make sure they are giving you the right medication, and remind them if you have allergies to any meds.
There are some inconsistencies in this article:
If Dr.Knoblock truly told the patient that she wasn't really in pain, then why would she have given her a prescription for pain medicine?
The article claims that the family has a respect for medicine and was not inclined to seek legal action until they spoke to a nurse at a Christmas party a year later, yet an autopsy was done which suggests the family was planning to sue. I can't help but ask one more question. Why does his series seem to target the St.Rose Hospitals disproportionately, which are based in Henderson? Is there a bias against a not for profit hospital system that seems to be thriving and extending into the Las Vegas market?
My ex-wife was operated on by Dr. Ripplinger, he was a family friend, and she had her gall bladder removed laparoscopically. When we met with him prior to surgery, he basically gave us this "Rosie walk in the park speech".
Two days after surgery my ex was in extreme pain and looking jaundiced. We called Dr. Ripplinger and he gave us a completely different story and remarked that, "all surgery involves pain". When I asked him about the jaundice, he remarked, that a stone had "gotten away from him and needed to work its way out."
She was bed-ridden and three days later, she finally passed the stone that was blocking the duct. I was relieved but pissed off.
The pre-op visit was not realistic AT ALL.
Two months after the procedure, two friends died from complications following laparoscopic surgery performed by completely different Doctors.
Our eyes were opened dramatically.
it would be nice if doctors would inform patients about possible complications. not just common side effects but things that could go wrong so patients can recognize problems when they arise.
My wife almost died at the hands of an arrogant doctor at University of Texas Medical Branch in Galveston. During gall bladder surgery, he left a stone in her bile duct just below the drain. The only reason to put in a drain would be to go back later and pluck it out (teaching hospital). We were told by the doctor who saved her life that it was too big to miss and he indicated that it was probably left on purpose. Further investigation showed just how many had died because of him! Fortunately for us, Hurricane Ike hit the area and put him out of business. We rushed her to Central Texas and they literally saved her life. She was misdiagnosed in Las Vegas in 2006. Funny how things work out for the best for some. We feel very lucky. I am grateful everyday for my wife of 32 years!
You have to keep an eye on these doctors.
I have lost my mother at UMC, due to a mishap in Surgery on one of her vertebrates. She was in so much pain, and they did the same thing. Told her she was crazy and should not be in that much pain. She eventually passed away a couple days later to a Infection in her Spinal Cord that they did not find.
We lost our first daughter at Valley about 6 years ago. Had us waiting, and did not tell us how serious that our baby's health was and asked us if we wanted UMC or Sunrise to come pick her up, because they were not equipped to handle her situation. Well not knowing how serious we choose Sunrise because of our previous experience with UMC. Well she died right when Sunrise got there. She had a heart defect that they did not find when she was born. And she was born there. Funny when we tried to get all our paperwork from there, some of it had disappeared. We had her death certificate before her birth certificate. It took over a month for the main doctor in the ER to put his notes in her file.
On a side note also, when dealing with her Pediatrician, who we called before going to the ER. He told us it was normal for a babies feet to be turning blue. OK, does that sound normal to you.
You just have to be careful and demand extra service that you may not get. A year later I had another daughter and had the best doctors, but they all knew ahead of time what I had experienced and double checked and sometimes tripled checked things with me and my baby. Even at Sunrise hospital, they did not give me any problems with I asked that an Echo be done on My daughters heart, which if it had been done on my first daughter, she might have been saved. They were all great, and took the extra steps to make sure that my daughter was healthy when I took her home. That is the only hospital I will go to now.
Why do you think doctors call it a.........Practice!
I would NEVER have elective surgery in this town, and hope I never need emergency surgery. There are some good things about the valley, but healthcare is not one of them.
The only way to be safe in the hospital/medical system anywhere is being well informed, having someone with you while in the hospital, and having a great advocate. There are mistakes and miscalculations in hospitals EVERYWHERE, not just Las Vegas.
Nowhere in this story is there mention of Mrs. Doyle's primary care doctor. When you have a good internist, who knows you and is by your side, you have the best advocate. Her primary care doctor would have known her pain threshold, her propensity for drama, problems post operatively, etc. Her primary care doctor would have found out why she was still suffering after an otherwise innocuous surgery. If you can't say your primary care doctor would do all this for you, GET ONE!!! Could be a matter of life and death.......yours.
Oh, someone just take an extra 5 minutes to listen to your patients. You could save a life, heartache and probably the loss of your license.
Do you know who knows your body the best? You should know yourself better than anyone else. Pay close attention to what your body is telling you, not just what the doctor says.
Look up Rate MDs and you will see how the physicians are rated by their patients.
My condolences go out to this family for their loss. It's quite clear that the doctors acted in the manner of 'we know better than you' what is happening to your body. This poor woman was in pain and instead of helping and investigating what the issue was they simply let her linger....and in turn caused her death. I've heard it said before and I think it's a valid point we need to be our own best advocates, as sometimes the medical establishment seems to forget The Hippocratic Oath and simply go on about their business. It's absolutely criminal that the family reached out for help repeatedly and were seemingly told to go away.
My wife is active duty AF here and just had her gall bladder and appendix out! fortunatly she had an amazing surgeon!who put her on 6weeks profile with pain meds. On the day before another friend of ours who knew she had gall stones had it removed also, but her AF Dr.didnt give her light duty or anything she's also in Maintenance like my wife they stuck her in CTK (tool shop)lifting 50 lb tool boxes!my wife wasn't allowed to pickup anything over 15 lbs!when our friend was still in terrible pain and went back to the hospital her Dr. accused her of being a drug addict! for asking for more pain pills! she just had a surgery where they break your jaw and move it so of course she had pain pills to recover from that.So i guess it's just a matter of luck on what kind of PERSON your going to get when you get assigned a Dr.I'm so sorry for this family i don't even want to imagine the pain this poor lady went through!!!!!
Oh MY God--
she just had a surgery where they break your jaw and move it so of course she had pain pills to recover
Man - enjoy life don't be an a/h if you are still healthy
everybody gets their turn in the barrel .
I am really sorry for this family's loss. That poor woman, what she had to go through before she died. It seems doctor's just don't give a fig anymore and it's always about the money. We need to go back to a time when doctor's were compassionate and actually spent more than 1 minute per patient. And did something about their distress instead of shooing them away. I would not tolerate it at all.
NoPatience is absolutely right. Read his comment again and take it to heart. It's too bad that many of the really good physicians in town are retired now. Neil Strauss was amazing, Malcom Poon was a great surgeon, Gary Kantor knew his way around a kidney and was very ethical. All retired now I believe.