Dialogue Volume 14 Issue 2 2018 - Page 70

DISCIPLINE SUMMARIES ultrasound appointment and blood work for the next morning. The ultrasound results suggested that the common bile duct was obstructed and blood work indicated that Patient X’s bilirubin had increased over the previous three days. Dr. Ghumman advised Patient X that the clip he was concerned about had actually been placed incorrectly and had likely caused obstruction of the patient’s common bile duct. He organized Patient X’s immediate transportation to London Health Sciences Centre for emergency ad- mission and surgery. Following the surgery, the hepatobiliary surgeon noted that there was a clip going across Patient X’s entire bile duct. The surgery was complicated by intra-operative and post-operative bleeding, which required transfusion of eight units of blood. Patient X remained hospitalized in London for approximate- ly one week after the surgery. In October 2015, the College retained an expert, a general surgeon, to provide opinion regarding Dr. Gumman’s care of Patient X. The expert opined that although the technical complication involving the clip applier during surgery was beyond Dr. Ghum- man’s control, his actions in response to the problem were below the standard of pr