December 26, 1995, 63 year old man has a laparoscopic inguinal hernia repair done, outpatient type surgery.

Labs before surgery show that he has a low white blood cell count.  (WBC)
Apparently this is a

chronic condition for this gentleman in that he has had prior surgeries without the low WBC being a problem.

After the surgery, he had crampy abdominal pain and nausea.

  On December 28th,

he sees the surgeon in his office and complains of pain at the site of the surgery, crampy abdominal pain, inability to keep anything down. 

Dr. decides it is due to the pain medication and he changes that. 

On December
29th,

he begins to run a fever of 101 and he is vomiting.  Doctor's office tells him to go to
the hospital emergency department.  Surgeon's partner is covering for the original surgeon.  He sees him in the emergency room and notes that he is ill appearing, abdomen is distended. 

Xray shows that the gentleman has an ileus vs. abdominal small bowel
obstruction. 

Lab work shows that his white blood cell count is 1.4 which is really low and
affects his ability to fight infection. 

Patient is admitted to the hospital, given IV fluids and given pain medications. No
antibiotics.

He vomits twice through the night and takes pain medication as often as he can. 
At 7 a.m. next morning while in xray department he dies.


The arguments:

Plaintiff contends that he died of overwhelming sepsis (because he didn't have
anything to fight the infection with because he should have had antibiotics when he came into the hospital for the hernia repair.) and he aspirated (because he should have had an nasogastric tube placed the evening before to empty his stomach). 

Defense contends that the patient did not have classic signs of infection (no fever recorded, no wound infection seen, CXR was normal).

The autopsy was botched so there was never any evidence of leakage from the
site of the hernia repair. 

What do you think about this case?
thanks,
Amy