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Towel, staple left inside University of Iowa cancer patient brings $1.2 million deal

Lawsuit says towel forgotten by surgeons was nearly 2 feet long

University of Iowa Health Care complex, which houses University of Iowa Hospitals and Clinics, is seen in this photo taken on Friday, April 18, 2014, in Iowa City, Iowa. (Justin Wan/The Gazette)
University of Iowa Health Care complex, which houses University of Iowa Hospitals and Clinics, is seen in this photo taken on Friday, April 18, 2014, in Iowa City, Iowa. (Justin Wan/The Gazette)

A surgical towel and silver staple left inside a Burlington cancer patient after an operation at the University of Iowa Hospitals and Clinics will cost a $1.2 million settlement, the state agreed Monday.

Joseph Lee Caskey, 46, sued the state and UI physicians Sam Brancato and Paul Kogan in April, nearly two years after severe pain and discomfort brought him back to UIHC for exploratory surgery — and the discovery of a towel nearly 2 feet by over 1 foot, or 57 by 35 centimeters, holding a staple in his abdomen, according to the lawsuit.

“The plaintiff had undergone initial surgery months prior and continued to be in contact with UIHC with various complaints until the exploratory surgery discovered the towel,” according to a Nov. 13 settlement, which the State Appeal Board approved Monday.

The state’s general fund will cover half the $1.2 million payout, with the other $600,000 coming from the UI Physicians group — the state’s largest medical and surgical group practice, with more than 1,000 UI Carver College of Medicine physicians who serve as the UIHC medical staff.

The deal includes attorney fees and releases the state and the UI from any further medical bills or liability related to the operation on Oct. 31, 2016 — when the blue towel and silver staple were left in Caskey, according to the lawsuit.

Neither Brancato nor Kogan are current UIHC employees, according to UI online databases. Brancato was a clinical assistant professor from July 2016 to July 2018, earning a salary of $223,140 at the time he left. Kogan was a resident physician from June 2012 to July 2018, earning $65,600 at the time he left.

Caskey initiated his care with the UI in January 2016 when he was admitted for an emergency procedure related to testicular cancer. Following chemotherapy, physicians recommended the removal of lymph nodes, and Brancato and Kogan on Oct. 31, 2016, removed a single mass and three lymph nodes from Caskey’s abdomen, according to the lawsuit.

The doctors left the foreign objects behind an area of Caskey’s small intestine in his stomach-bowel region, the lawsuit asserts.

For the next seven months, Caskey experienced “severe multiple physical problems” and returned to the UIHC in search of a cause and treatment. But doctors initially failed to find the towel. That’s when UIHC physician Luis Garcia on June 6, 2017, went back in for an exploratory laparotomy.

He found the towel and staple, removed them, and — due to “severe internal injuries” caused by the objects — performed additional procedures, according to the lawsuit.

Caskey had to be hospitalized for 10 more days. He was released with drain and feeding tubes in place.

He was placed on a clear liquid diet, and instructed to use his feeding tube for nutrition. The tubes eventually were removed and Caskey reported continuing to recover although he suffered permanent injuries, the lawsuit alleged.

Attorneys for the state and the UI denied in court records failing to exercise the degree of skill and care exercised by other physicians in similar circumstances.

Other settlements the State Appeal Board approved Monday include nearly $1 million to the family of an almost-four-month-old baby who died after being seen at UIHC and sent home.

That infant had been born with a known congenital heart disease and on the date of her death had come in to UIHC after spending the night and morning vomiting, struggling to breath and coughing, according to the family’s lawsuit.

She was treated and sent home, where she died the same day, according to the lawsuit.

Comments: (319) 339-3158; vanessa.miller@thegazette.com

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