In 2004, as a teenager, C.S received an Antegrade Continence Enema (ACE) Malone procedure to relieve chronic constipation and urinary symptoms due to her spina bifida. The ACE procedure is a surgical procedure in which allowed C.S. to have a traditional bowel movement. The ACE was an irrigation system where C.S. was able to insert a catheter in an opening near her belly button that ran fluid through her bowel to help push the stool through the bowel.
In 2011, a doctor performed a diagnostic laparoscopy and noted that the appendix was densely adherent to the abdominal wall and that this could be conceivably causing C.S.’s pain. The doctor removed the appendix without consulting C.S. or her family about why it was placed where it was. Because the appendix was removed, the connection allowing irrigation facilitating rectal stooling was gone. As a result, C.S. no longer had independent bowel management and relied on her mother to manually extract stool for approximately 18 months.
She now has a new bowel evacuation regiment that gives her similar relief, but rather than the irrigation starting near the belly button, the irrigation begins from the rectum. Defendants argued that the ACE procedure was not functioning at all, and at best poorly, at the time it was disconnected. Defendants argued that the ACE procedure was not going to provide C.S. with assistance with her bowel evacuation much longer and she ultimately was going to need a new system to evacuate her bowel anyway, despite it being disconnected. The case settled for $500,000.
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