The Law Firm of Carlton F. Bennett, PLLC and The Rawls Law Group recently concluded a $542,000 settlement in a case involving a patient who suffered a permanent bladder injury due to nursing negligence. The plaintiff was an otherwise healthy 72-year-old man who had a total knee replacement. Before the surgery he was on no medications and very active.
The surgery itself was uneventful. The patient had last urinated about two hours before the procedure. Following surgery, there was no urine output in the PACU, which was not necessarily alarming because a spinal anesthetic had been used. He was discharged from the PACU and sent to the floor. Unfortunately, no one checked his urine output until well past midnight, about 14 hours after the patient had last urinated.
The nurses drained 3000 ml of urine from the patient’s bladder – more than three quarts. The bladder typically holds one sixth of that amount, about 500 ml, when full. The bladder is a muscle and, therefore, elastic. It squeezes to expel urine. Unfortunately, the huge amount of retained urine stretched the bladder too far. It lost its elasticity.
The patient never regained his bladder function and now must self-catheterize four times a day for the rest of his life. The impact of this permanent injury is, of course, far-reaching, including with regard to his relations with his wife of many years.
The defense was that the patient had an abnormally large bladder for many years and, therefore, he was probably going to lose urinary function regardless. He likely did have a large bladder beforehand, but there was also no dispute that he had no bladder or urinary problems prior to the retained urine injury.