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Surgeon Removed Liver Instead of Spleen, Family Says

— Pathologist finds liver instead of splenic tissue

MedpageToday
A photo of a surgeon holding a scalpel in white rubber-gloved hands.

An Alabama woman is seeking legal action against a surgeon whom she alleges removed her late husband's liver instead of his spleen.

On the evening of August 21, Thomas Shaknovsky, DO, operated on 70-year-old William Bryan to "remove his spleen but removed his liver instead," Beverly Bryan said during a Tuesday press briefing with her lawyer, Joe Zarzaur of the Florida-based firm Zarzaur Law.

"Everyone knows you can't live without your liver. It's about the same as if they pulled out your heart," Beverly Bryan, a retired nurse, said during the briefing. "The loss of my Bill was exceptionally unnecessary and brutal."

William and Beverly were at their vacation condo in Destin, Florida on Sunday, August 19, when William started having pain on his left side and in his left shoulder. They went to Ascension Sacred Heart Emerald Coast Hospital in Destin, where he was admitted.

William had multiple CT scans and an MRI, and doctors concluded that his spleen was enlarged and they were concerned about a possible malignancy, according to the operative report. There also appeared to be internal bleeding, and over the course of his stay his hemoglobin levels dropped from 14 to 9, Beverly said.

Though the family wanted to be discharged to their home in Alabama so they could have surgery at a familiar hospital, Beverly said doctors were concerned it was too risky to transfer him.

Instead, William went in for surgery around 6 p.m. on Wednesday, August 21, Beverly said. The operative report stated that the spleen was "noted to be severely deformed," and due to its large size, "we elected to convert to open procedure."

However, during surgery, Shaknovsky discovered a splenic artery aneurysm, which ultimately ruptured. "Extensive intra-abdominal blood loss was sustained, severely precluding visualization of key anatomical structures at the hilum," the report stated.

Still, "due to extensive blood loss ... patient's blood pressure decreased abruptly and patient decompensated into cardiac arrest," the report stated.

Next, the spleen was removed and sent to pathology, and the code was called about 20 minutes after the initial arrest, according to the report.

The pathologist report, however, stated that there was "no splenic tissue identified." Instead, the pathologist wrote that it was a "grossly identifiable 2,106 g liver."

The pathologist notified the medical examiner, who conducted an autopsy, revealing that William "still had his spleen in his body but was missing his liver," Zarzaur said during the press briefing. The spleen had a mass, but it was benign, Zarzaur said.

"The spleen had a small cyst that had some hemorrhage around it, but it was not a fatal or dangerous issue," Zarzaur said. "It was a fairly routine looking cyst that probably would have been very treatable."

The family hasn't filed a lawsuit yet because medical malpractice lawsuits in Florida must first go through a pre-suit process, which can take 6 to 9 months, Zarzaur said, adding that the process has not yet started in this case. He does not think this case can be resolved through that process because the hospital's responsibility in the case may be debated.

The Walton County Sheriff's Office said it's "reviewing the facts involving the death of William Bryan to determine if anything criminal took place," along with the medical examiner and state attorney general.

In an emailed statement, Ascension said it "take[s] allegations like this very seriously, and our leadership team is performing a thorough investigation into this event."

It added that patient safety "is and remains our number one priority" and its "thoughts and prayers remain with the family" but it does not comment on "specific patient cases or active litigation."

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.