Simple surgery goes awry for Warren man
Daryl Bohning walked into Danbury Hospital in June 2011 for routine, elective surgery to repair a hernia.
More than a year later, Mr. Bohning and his wife, Sue Ellen Bohning, said he has been left weakened and shaken by his experiences.
That supposedly simple operation punctured his bowel, which an emergency room doctor failed to diagnose when Daryl returned to the hospital after his first surgery, the Bohnings said.
The peritonitis resulting from the perforated intestine infected Daryl Bohning's blood and shut down his kidney, and he needed two major surgeries to repair his bowel, according to hospital records.
Mr. Bohning and his wife said he has never truly recovered.
"I still can't lift things," Mr. Bohning, 70, said at his home in Warren earlier this year. "I have trouble breathing. My body is still sore, especially under the breast bone."
"He used to be strong as an ox," Sue Ellen Bohning said. "He was doing yoga, he was eating healthy foods. He was doing everything right."
"This has aged me five to 10 years." Daryl Bohning said.
The hospital never apologized to Daryl or Sue Ellen Bohning, they said.
Linda McGrory, Danbury Hospital's director of patient relations and service excellence, wrote to the Bohnings on March 25, 2012.
Ms. McGrory said the hospital had done a "thorough, thoughtful and robust review" of what happened.
While acknowledging "post-operative complications" occurred after the first attempt to repair Daryl Bohning's surgery -- requiring a second serious repair -- Ms. McGrory wrote that a hospital review did not find errors on any of the staff's part.
Ms. McGrory said Mr. Bohning's first surgeon, Dr. Laura Choi, explained the risks and benefits of the procedure to him.
"It is indeed unfortunate that post-operative complications" followed Mr. Bohning's second surgery, Ms. McGrory wrote.
However, the hospital's review concluded that complications did not reflect surgical error, she said in her letter.
"We appreciate the opportunity to review your continued concerns," Ms. McGrory wrote. "Please know that they have been thoroughly examined."
It is that letter, which Sue Ellen Bohning calls "a total insult," that has really raised the Bohnings' ire.
"I want an apology for that letter," Sue Ellen Bohning said.
But, she said, she and her husband have no sense that anyone will listen to their concerns about what happened at Danbury Hospital.
They have lodged complaints with the state Department of Public Health and the state attorney general's office.
The public health department's investigation found the hospital had failed to evaluate Daryl Bohning's pain properly. It did not address whether the hospital had been at fault for failing to see that his hernia operation had gone so seriously wrong.
Asked to comment on the case, Andrea Rynn, spokeswoman for Western Connecticut Health Network -- which manages Danbury and New Milford hospitals -- said, "We are obligated by, and will respect, the federal and Connecticut patient privacy laws that prohibit us from commenting on any patient's care."
Ms. Rynn, who said she was also speaking on behalf of Dr. Choi and other network employees involved in the case, added, "Patient safety remains a top priority for our organization."
HOW IT ALL STARTED
The Bohnings' story began in May 2011, when Daryl Bohning decided to have hernias on both sides of his lower abdominal wall repaired, after years of ignoring them.
"I delayed it for a very long time," he said.
Dr. Choi did the surgery. She works at the hospital as a general surgeon. She's also the medical director of the hospital's Center for Weight Loss Surgery and holds the Fred and Irmi Bering Chair in Laparoscopic Surgery.
In April 2012, she was on the cover of Connecticut Magazine's feature on the state's top doctors.
Laparoscopic surgery -- a minimally invasive technique -- is the procedure of choice for hernia surgery. Patients can usually go home on the same day as their surgery, and recovery time is shorter than with traditional surgery.
Daryl Bohning said Dr. Choi told him because of scar tissue in his abdomen from previous surgery, she might not be able to do a laparoscopic procedure.
"I wasn't worried about that," he said. "I felt, `Do it right.' "
Dr. Choi performed the surgery June 16, 2011.
She called after to say she was able to perform laparoscopic surgery after all, Mr. Bohning's wife said. The conversation was brief and hurried, Sue Ellen Bohning said.
After the first surgery
Visiting her husband in the recovery room, Sue Ellen said, she found him in agony, and the staff prescribed pain medication -- oxycodone -- to help him recover. Daryl was discharged the same day, she said, and she drove her husband home to Warren, a nearly hour-long trip from Danbury.
The pain medication didn't help, she said, and she phoned Dr. Choi that night. Because Dr. Choi was not in the area, Sue Ellen Bohning said, she talked instead to Dr. Choi's associate, Dr. Keith Zuccala.
Here, Sue Ellen Bohning said, she may have made a mistake. She said Dr. Zuccala told her to bring her husband back to the hospital if the pain medication didn't give him relief.
Exhausted by the events of the day -- she had gotten up at 3 a.m. to drive her husband to his surgery -- and unaware the Warren Volunteer Ambulance makes trips to Danbury, she decided to sleep for a few hours, she said.
At 6 a.m. on June 17, the Bohnings said, they drove back to Danbury Hospital, expecting to meet Dr. Zuccala at the hospital's Duracell Center for Ambulatory Surgery.
When the Bohnings got to the hospital, they said, they were told to go to the emergency room. There, they said, Dr. Joseph Muratori examined Daryl Bohning.
Despite her husband's extreme pain, Sue Ellen Bohning said, Dr. Muratori never took x-rays or a CT scan or did follow-up blood work.
No surgeon came in to examine Daryl Bohning, his wife said. Instead, the Bohnings said, Dr. Muratori prescribed Dilaudid -- a stronger pain medication -- and sent them home again to Warren.
In her March 26 letter to the Bohnings, Linda McGrory said because Daryl Bohning came to the emergency department complaining of pain, doctors consulted his charts and treated him for pain.
"Lab testing and radiology studies were not indicated based on symptoms present during time of treatment," Ms. McGrory wrote.
BEHIND THE PAIN
Yet Daryl Bohning was not experiencing ordinary post-operative pain. He had a perforated small intestine and was suffering from peritonitis, infection of the peritoneal lining of the abdominal cavity, according to later hospital records.
On the evening of June 17, 2011, Daryl's kidneys began to fail. The small amount of urine he was producing was very dark. He was sweating. His hands were cold and pale.
"If I had waited another day, he would have died at home," Sue Ellen Bohning said.
The people who saved Daryl's life, the Bohnings said, were two friends who are doctors. They came to the house, saw how ill he was, called Dr. Zuccala and alerted him to what they saw, the Bohnings said.
Once again, Daryl Bohning was admitted to Danbury Hospital, this time on June 18.
Dr. Zuccala operated to remove a section of infected small intestine. Hospital records show at the time Mr. Bohning was suffering from peritonitis, septic shock -- blood poisoning -- acute renal failure and heart irregularities caused by the infections.
Mr. Bohning spent the next nine days in the hospital's intensive care unit. Doctors also discovered a leak in his intestines after Dr. Zuccala's repair surgery.
Mr. Bohning needed a third operation on June 26, 2011, to repair it.
In a consulting report, Dr. Abhijith Hegde, a pulmonologist, called Mr. Bohning "an unfortunate 69-year-old male," who had undergone three surgeries within two weeks.
In response to the Bohnings' complaint, the state Department of Public Health has asked the hospital to amend its protocols for post-operative pain evaluation.
Yet the department did not rule on the perforated intestine, on what the Bohnings contend was Danbury Hospital's failure to recognize that damage, or on the leak that necessitated a third surgery.
As a result, the Bohnings said, they have now contacted the state attorney general's office with their complaints.
Daryl Bohning is 70 years old. He has recovered from the events at Danbury Hospital in the sense that he is walking and his organs are functioning.
But he said he is weakened, in pain and depressed.
Sue Ellen Bohning said because of her husband's age and his recovery, and because he is on Medicare, medical malpractice attorneys aren't particularly interested in the case.
Yet, she said, she still wants four things:
First, she said, she would like justice and compensation from Danbury Hospital.
"Daryl can no longer do the things he did before," she said in a written list of her complaints. "He is weak, in pain, with trouble breathing."
She would like officials with the state Department of Public Health to take stronger action against the hospital, she said.
She would like more of a safety net, she said, for patients after surgery -- especially those who live an hour's drive away.
And, Sue Ellen Bohning wrote, "We want to be treated with some dignity and compassion."
Ms. McGrory's letter, she wrote "was really a brush-off."
"I want Danbury Hospital to recognize they're running a factory there," Sue Ellen Bohning said. "They just can't treat people like that. I want an apology for the letter we received from Danbury Hospital and Linda McGrory.
"And I'd like the hospital to say that if Daryl needs more care because of all this, the hospital will pay for it."
Whether any of this will happen, Mrs. Bohning said, is far from clear. "I don't have any way of knowing."