Surgical tool left in patient’s abdomen, found after almost 14 years

A surgical team allegedly left a 15-centimeter long surgical clamp in the abdomen of a patient during surgery to address her irregular periods and ovarian cysts at the Commonwealth Health Center on Saipan in August 2000. It was in June 2014—or almost 14 years later—when the surgical clamp was discovered and removed at Guam Memorial Hospital.

Following the CHC surgery, the patient, Remedio Elameto, claimed to have experienced irregular periods, pain, fatigue, sleep disruption, interference with her activities of daily living, and reduced interest and ability to enjoy activities she had previously engaged in.

Elameto and her common-law husband, Pedro Pua, are suing the CNMI government and two former CHC doctors Rajee Iyer and Gary Ramsey for medical malpractice, bad faith, and emotional distress and loss of consortium.

Elameto and Pua, through counsel Claire Kelleher-Smith, asked the Superior Court to hold the defendants liable to pay them damages, court costs, and attorney’s fees. They demanded a jury trial.

The plaintiffs also requested the court to issue a declaration that the liability limitations of the Government Liability Act are unconstitutional because such limits deny tort victims such as them, equal protection of the laws.

According to Smith in the lawsuit, during the CHC surgery on Aug. 2, 2000, Elameto was placed under general anesthesia and hospital employees cut open her abdomen and performed an exploratory laparotomy. They removed cysts from her fallopian tubes.

Iyer was the primary surgeon and Ramsey provided assistance.

Smith said while Elameto was unconscious and enduring the surgery, CHC employees closed her abdomen without removing the 15-centimeter long surgical instrument.

Smith said Elameto attended follow-up appointments at CHC, however, she did not feel better after the surgery and was not comfortable returning to the hospital for treatment.

When her daughter moved to Guam, Elameto took the opportunity to stay with her and seek medical treatment.

Smith said Elameto visited a gynecologist in Guam who referred her to Dr. Friedrich Bieling at Guam Memorial Hospital.

Bieling scheduled a total abdominal hysterectomy with bilateral salpingo-oopherectomy.

Smith said, however, on June 10, 2014, as Bieling was performing the surgery on Elameto, he discovered a cystic mass “buried under dense adhesions and covered with a layer of dense adhesions” that was “difficult to dissect and retract.”

Bieling discovered a “solid object” buried inside and “it was found to be a hemostat left from previous surgery.”

Bieling required the assistance of a second surgeon, Dr. Ronald Kobayashi, to remove the adhesions and what was discovered to be a 15-centimeter long hemostat.

Kobayashi had to perform a partial omentectomy to remove the hemostat.

Smith said the CNMI was negligent in failing to have standard procedures in place to protect against leaving foreign objects in the bodies of patients after surgery.

Smith said the staff and employees of CHC and Iyer and Ramsey failed to record and track the instruments used during surgery so that each instrument would be removed from Elameto’s body.

Elameto submitted her claim to the CNMI, by presenting it to the CNMI Attorney General on March 1, 2016.

Smith said despite the incontestable negligence of CHC employees and the indisputable harm to Elameto—including the need for an additional surgery, the records of which were provided to the Office of the Attorney General—the AG denied her claim.

Smith said the AG, through the deputy AG, asserted that Elameto’s claim is barred by the two-year statute of limitations, even through Elameto brought her claim less than two years after she discovered the negligence of CHC’s surgeons and employees, and less than two years after she had the hemostat removed from her body.

Smith said the deputy AG stated that Elameto did not exercise “reasonable diligence” in discovering that CHC employees left a surgical instrument in her body.

“This denial of Remedio’s claim is unreasonable, malicious, made in bad faith, and made with a reckless disregard of her rights,” the lawyer pointed out.