Types of Medical Malpractice
The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate bile produced by the liver. Bile is released from the gallbladder after eating, which aids digestion. In order to remove the gallbladder, the physician must correctly identify both the cystic duct and the cystic artery, which are ultimately cut and clipped so that the gallbladder can be removed.
If there is one overriding principal that deals with the standard of care during a laparoscopic cholecystectomy, it is unanimously that:
The safety of laparoscopic cholecystectomy requires correct identification of relevant anatomy. Guidelines for the Clinical Application of Laparoscopic Biliary Tract Surgery - Society of American Gastrointestinal and Endoscopy Surgeries
The relevant anatomy must be correctly identified because the one thing that you never want to do during a laparoscopic cholecystectomy is cut the common bile duct. Doing so can result in a whole host of serious complications including strictures, choloangitis, pancreatitis, infections, adhesions, the need for additional surgeries, and even death.
In order to remove the gallbladder during a laparoscopic cholecystectomy, it is necessary to clip and cut both the cystic duct and the cystic artery. The standard of care universally provides that before a physician cuts and clips the cystic duct or cystic artery, the physician must be 100% sure of what he or she is cutting.
An acute peripheral arterial occlusion is defined as a sudden decrease in limb perfusion that causes a potential threat to limb viability. If this condition develops, it is a vascular medical emergency which requires prompt recognition and treatment within a limited timeframe. When it occurs, blood flow to the affected limb will slow or stop, the tissues will ultimately begin to die, and if blood flow is not restored amputation is not just a possibility, it becomes a certainty.
Acute arterial occlusion in an extremity must be treated as a medical - surgical emergency since not only the affected limb is in danger but the life of the patient as well. Therapy of Acute Peripheral Arterial Occlusion, HERZ.1991, December; 16(6):456-62
Acute limb ischemia occurs when there is a sudden arterial occlusion resulting in an abrupt cessation of flow to an extremity. Acute limb ischemia is a surgical emergency mandating urgent extremity revascularization to avoid the need for amputation. Critical Limb Ischemia, October 27, 2016, Panko/Belcha Chapter 5
The “golden window” of time that is recognized as being the limits of when a limb can reasonably be salvaged under such circumstances is generally considered to be 6 to 8 hours. As time progresses, the chances or saving the limb dramatically decrease. Because of this limited timeframe, the window of opportunity must always be in the treating physician’s mind. There is a finite amount of time to react once the clock starts running.