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Case Overview:
Our client was diagnosed with ectopic adrenocorticotrophic hormone ("ACTH") his adrenal glands were producing excessive level of cortisol.
He was initially treated with medication but he was advised that such treatment was temporary and he would ultimately require removal of both adrenal glands.
Despite the option of bilateral adrenalectomy being available, a decision was made to proceed initially by way of a left adrenalectomy and thereafter, following a period of recuperation, to undertake a right adrenalectomy.
He was admitted to hospital to undergo a left laparoscopic adrenalectomy. At surgery, the operation note indicates that a “massively enlarged” adrenal gland was identified, which was described as expanding in front of the renal vessels and below the pelvis of the kidney. In the course of dissecting the mass off the renal vessels, severe bleeding was encountered which necessitated converting the surgery to an open procedure. Ultimately however, the operation note confirms “adrenalectomy completed”.
Despite the content of the operation note, the subsequent histology report revealed that the left adrenal gland had not been removed. CT examination confirmed that the left adrenal gland remained in situ; the surgery that had in fact been undertaken was a partial pancreatectomy up to the pancreatic neck.
In the aftermath of his surgery, he required prolonged admission to the intensive care unit and his condition was complicated by pancreatic leak and sepsis. He underwent a bilateral adrenalectomy and a splenectomy, the latter procedure being required in order to repair the injury to the pancreas created at his initial surgery.
This case was mediated a week in advance of the trial and ultimately settled for a substantial sum.