Surgeon Accidentally Removes Kidney During Emergency Procedure

Case Overview

This case involves an obese 51-year-old male in Colorado who was admitted for ischemic chest pain. The patient had an EGD that was negative. The patient was found to have a polyp in the colon that was removed and an ulcer in the small intestine was noted and biopsied. After the colonoscopy, the patient had severe abdominal pain and was hypotensive. A CT scan showed evidence of a splenic laceration and resulting blood in the peritoneal cavity. The patient was taken to the operating room. During the procedure, the patient’s kidney was accidentally removed with the spleen. The patient later developed an infection secondary to his kidney removal.

Questions to the Nephrology expert and their responses

How often do you see patients who have had a surgically removed kidney?

Over my 41 years of practice as a physician, and specifically as a nephrologist since 1982, I have seen patients with nephrectomies for cancer, kidney donation, and surgical incidental iatrogenic complications. I have seen this occur several times. It would be difficult to say how many per year. With the advent of laparoscopy and improvement in renal biopsy techniques they occur less frequently.

In general, what aspects of a patient's medical chart are important in determining any effect removal of a kidney would have on a patient's future prognosis?

My research and clinical focus has been two-fold as specifically related to this case. I have also been the principal investigator, consultant, and/or researcher for projects to measure hormones that are affected by pharmacologic and non-pharmacologic therapies to prevent renal failure and preserve kidney function. In this case the combination of renoprotection and experience in having one vs two kidneys as well as my experience in this patients 'presumed nephrosclerosis' (the blood vessel disease in the carotids and heart are everywhere including the kidneys) all allow me a greater understanding to allow the courts and clearer picture of how the nephrectomy will impact this patient's past, current and previous health.

About the expert

This well qualified and double board-certified nephrologist earned both his BS and MD from Boston University. He then went on to complete an internship in internal medicine at Georgetown University, a residency in internal medicine at Tufts University followed by a fellowship in nephrology at Boston University. He has published over 80 peer-reviewed articles and is a member of several professional organizations including the International Society of Nephrology and the American Society of Nephrology. He formerly served as a clinical associate professor of medicine at Brown University and is currently a professor of nephrology at a top medical university in Boston, the chief of nephrology at a medical center in RI, and an affiliate faculty member at several other hospitals across MA and RI.