State to pay estate of man who died after a blade was left in body during surgery

CHARLESTON, S.C. (WCSC/Gray News) – The estate of a man in South Carolina was paid $1 million by the state after a blade was left inside his abdomen during surgery, resulting in his death.

In January 2022, Jeffrey Alan Fulcher was diagnosed with localized carcinoma in the lower part of his esophagus and was referred to the Medical University of South Carolina for treatment.

A lawsuit states that Fulcher responded well to treatment, and by May, he had completed a full course of radiation and chemotherapy.

A few months later, on June 15, 2022, Fulcher underwent a minimally invasive procedure to remove part of his esophagus as was recommended by his medical provider, Dr. Ian Bostock Rosenzweig.

Documents state that, at some point in the surgery, a Thompson retractor blade fell into or was placed inside Fulcher’s abdominal cavity. Bostock failed to see or remove the retractor blade and closed his abdominal cavity with the blade still inside Fulcher’s body.

Nurses inside the hospital’s operating room also counted all instruments and blades both before and after surgery, confirming no blades were unaccounted for.

A day after the surgery, Fulcher informed his providers of pain in his abdomen. However, doctors determined he was “doing well,” according to the lawsuit. Fulcher continued to alert his providers to pain over the next two days.

On June 19, Fulcher’s family members were visiting him at the hospital and said they saw a pronounced decline in his condition. Tests revealed his heart rate was over 100, but Physician Assistant Leanne P. Hewitt determined Fulcher looked “dry” and gave him fluids.

The retractor blade remained in Fulcher’s body, undiscovered, for five days and causing increasingly severe pain and eventually perforated his colon.

According to the lawsuit, Fulcher’s oxygen saturation level dropped around midnight and his abdomen was distended. An X-ray was ordered at 2:00 a.m., and a radiology report stated a “large volume pneumoperitoneum,” which is a medical emergency that requires immediate intervention.

The findings were discussed, and over two hours later at 4:42 a.m., a note was entered determining that another round of imaging was necessary to conclude that the blade was actually still inside of Fulcher’s body instead of sitting on top of his pelvis.

It was not until just before 7 a.m. that Fulcher’s wife received a call from Bostock, who explained a small object had been left inside her husband during surgery and that a “quick-twenty-minute” surgical procedure was needed to remove “the metal piece.”

Fulcher’s vitals were taken once more before going into the operating room. At that time, he was in full-blown septic shock, according to documents.

More than six hours after providers found the blade, doctors performed an exploratory laparotomy where the dead portion of Fulcher’s colon was removed. Later that afternoon, Fulcher underwent a second emergency procedure out of concern for ongoing bowel ischemia.

The lawsuit said that Fulcher was then too unstable to be taken back into the operating room, and the procedure was performed at his bedside. The entirety of his colon was removed.

Fulcher died on June 21, 2022, at 2:30 p.m. His cause of death was listed as sepsis, peritonitis, colonic perforation and a retained surgical instrument in the abdomen from initial esophageal surgery.

Fulcher was just 58 years old at the time of his death. He left behind his wife of more than 34 years and their three children, according to documents.

The lawsuit stated that Fulcher’s death and injuries were a direct result of failures by the Medical University of South Carolina and its providers. It also claims the hospital and its agents were negligent, careless, grossly negligent, reckless and willful in violation of their duties.

Because the hospital is associated with the state, the state insurance fund paid Fulcher’s estate $1 million.