Mr M, a 49-year-old man, presented to the emergency department with complaints of abdominal pain. He was diagnosed with diverticulitis and a perforated colon and underwent a sigmoid colectomy and colostomy.

Six weeks later, Dr A performed surgery to reverse the patient’s colostomy. The patient was kept in the hospital postoperatively for observation. During the days after the reversal surgery, Mr M’s recovery appeared to be progressing normally. Dr A was involved in the patient’s postoperative care and saw Mr M several times at the hospital.

However, during the fourth night after the surgery, Mr M complained to the night shift nurses that he was experiencing pain. He called his 75-year-old mother at 5:30 AM, told her that he was in terrible pain, and asked her to come to the hospital as quickly as possible.

His mother, Mrs M, arrived at the hospital at 6:45 AM and went to her son’s room, where, she later testified, she saw him panting, breathing heavily, and vomiting bile. Mrs M reported this to the nurses.

At 7:00 AM, Nurse N took over as the day shift nurse. She was told by the overnight nurse that Mr M had been complaining of pain. Nurse N evaluated the patient and observed that his stomach was distended and tender to the touch. Knowing that this was not normal for a postoperative patient, Nurse N called the surgeon and informed him that Mr M had pain, abdominal distension, and tenderness and was complaining of shortness of breath.

Dr A expressed concern about the abdominal distension. He had seen the patient the night before, and these symptoms indicated a sudden change in Mr M’s condition. He ordered an urgent radiograph and instructed Nurse N not to let the patient have anything by mouth except ice chips.

At 7:30 AM, Nurse N entered the order for the abdominal radiograph. A few minutes later, Mr M’s mother, becoming increasingly distressed, asked when the physician would arrive.

At 8:00 AM, Nurse N again called Dr A. She asked the surgeon when he would arrive at the hospital and advised him that Mr M had not been taken yet for his radiograph. The surgeon told her that he was on his way.

After her phone call with the surgeon, Nurse N evaluated the patient again. At this time, Mr M showed abnormal vital signs, including a high respiratory rate, labored breathing, elevated body temperature, high peripheral pulse rate, and low blood pressure.

Dr A had not arrived at the hospital by 9:00 AM, and the patient’s mother was distraught. Nurse N called the surgeon again and was told that he was on his way. Nurse N then transferred the call to the patient’s mother so she could speak to the physician directly.  “My son is in a lot of pain,” Mrs M told Dr A, as she relayed Mr M’s symptoms. “I’m really concerned because things keep getting worse and worse.” Mrs M urged the surgeon to get to the hospital as soon as possible.  “I will be there at 10:00 to see you,” replied Dr A.

The patient was taken for a radiograph at 9:20 AM. When he returned approximately 30 minutes later, he was having increasing difficulty breathing. Since lying down made breathing more difficult, he sat in the chair in his room. His mother remained with him.

Nurse N was contemplating calling Dr A for the fourth time when she heard Mrs M calling for her. When she arrived to the patient’s room, she saw that he was unconscious. According to his mother, “he had stopped breathing as we were talking, and then he began foaming at the mouth and his eyes rolled back.” Nurse N called the rapid response team at 10:49 AM and a Code Blue was activated.

The team attempted to revive the patient. The hospitalist called Dr A, who had still not arrived, to inform him that Mr M had coded. The hospitalist was told that the surgeon was on his way. The patient could not be revived and was pronounced dead at 11:09 AM. Dr A did not arrive to the hospital until 11:30 AM, approximately 20 minutes after the patient had died.

The patient’s mother had a private autopsy performed to learn the cause of death, which was identified as sepsis caused by a leaking anastomosis. Mrs M sued Dr A and the hospital. The hospital was sued solely based on the alleged negligence of its employee, Nurse N.