The highly technical nature of most surgeries may make it challenging for laypeople to determine malpractice — as accepted legal doctrine holds — but some bodily functions are clear enough that just about anyone can make the right judgments.

So says the North Carolina Court of Appeals, which reversed a lower court's decision to dismiss a malpractice suit against Duke University Health Systems and 2 doctors who, after surgery to remove a section of small intestine, attached the plaintiff's intestine to her vagina instead of reattaching it to her rectum, according to an account in the (Durham, N.C.) Herald-Sun.

The hospital, along with Christopher Mantyh, MD, and Erich S. Huang, MD, had argued that the case should be dismissed because legal doctrine holds that most medical treatment involves certain risks and only an expert can determine whether a poor outcome rises to the level of malpractice. Dr. Mantyh, the chief of gastrointestinal and colorectal surgery at the hospital, performed the surgery, assisted by Dr. Huang, a general surgery resident.

Durham County Superior Court Judge Orlando Hudson agreed, tossing the case, but that decision was overruled by the Court of Appeals, which noted that another judge had already refused a motion to dismiss and that "one judge may not reconsider the legal conclusions of another judge."

Further, the Court of Appeals said, despite the technical nature of surgery, it's "common knowledge and experience that intestines are meant to connect with the anus, not the vagina, even following a surgical procedure to correct a bowel problem."

The appeals court upheld Judge Hudson's decision to dismiss punitive claims, saying there was no evidence that the defendants' conduct was willful, wanton, malicious or fraudulent.

Jim Burger