The Boone Case
Chronic mesenteric ischemia is the slow occlusion or blockage of abdominal blood vessels supplying the bowel. It is a painful process that causes bowel-emptying diarrhea or vomiting immediately after every meal as the intestines scream for the blood needed to digest food but the intestines can’t get the blood they need through clogged vessels. Mesenteric ischemia can be treated the same way heart disease is treated——by opening narrow vessels with stints or bypassing blocked vessels with surgery. Chronic mesenteric ischemia leads to severe weight loss and biological anorexia as the intestines slowly fail and the person can’t tolerate eating. If treatment is delayed too long the entire bowel dies from blood starvation and this often leads to the patient’s death as well.
In the six months it took her physicians to diagnose her chronic mesenteric ischemia, this 49 year old married woman suffered through a 35% weight loss (down to 65 lbs.). Her abdominal pain was unrelieved by narcotics and at times left her writhing on the floor in pain.
The primary care physician and her endocrinologist chronicled her dramatic downward course as her gastroenterologist misinterpreted successive diagnostic tests including upper GI, endoscopic evaluation of her upper GI system and colonoscopy. The patient admitted herself to the Forbes Regional Hospital Emergency Room three times due to her severe pain and substantial weight loss. On each occasion, a covering gastroenterologist made the correct tentative diagnosis of bowel disease and possible bowel ischemia but these opinions were ignored by her treating gastroenterologist, primary care physician and endocrinologist. Eventually, the covering gastroenterologist and a surgeon prevailed and an intestinal angiogram was ordered. By that time her entire bowel had infarcted (died from lack of blood supply) and had to be removed in successive surgeries. She died within three months.
Suit was filed in Allegheny County alleging delay in diagnosis by her several physicians. The covering gastroenterologist was dismissed from the case and a substantial settlement was reached with the remaining defendants in favor of her surviving husband and two adult children.