CREDENTIALS & BACKGROUND

Counsel commenced the deposition under the state's Civil Practice Act, waived formalities, and reserved objections until trial or first judicial use 1. The physician identified as a medical doctor who graduated from medical school and completed a general surgery residency at a charity hospital system with a year at a teaching clinic 2. He has practiced general surgery in Georgia since that time, performing breast, thyroid, abdominal, and soft-tissue procedures as well as vascular access work 3. He confirmed licensure in Georgia, current hospital affiliations, and recognized the patient's chart as Plaintiff's Exhibit No. 1 4.

INITIAL EVALUATION

He testified he was on emergency-room call in the early morning hours, finished an operation, and first evaluated the patient at approximately 4:00–4:30 a.m. as the on-call general surgeon 6. On arrival she had severe crampy abdominal pain, marked tenderness and distention, tachycardia, a WBC count around 17, and a CT scan interpreted as small-bowel obstruction with free fluid 7. The team obtained blood gas and lactate studies; results showed metabolic acidosis with lactate near 3.5, pH 7.16, and bicarbonate near 15 8.

OPERATIVE DECISION & FINDINGS

The team deferred bowel resection initially because serosal discoloration can be reversible and mucosal injury may recover with restored blood flow 15. In the ICU, the patient required ventilatory support and vasopressors and was returned to the OR the following morning, at which time portions of bowel had not recovered and the proximal jejunum appeared necrotic 17. Surgeons resected one large necrotic segment plus two smaller pieces to obtain viable margins 18.