Man's bowel perforated during surgery, leading to massive lawsuit

By Stephanie Srakocic | Fact-checked by Barbara Bekiesz
Published May 15, 2024

Key Takeaways

  • A Maryland man’s bowel was perforated during surgery on his left kidney.

  • The man passed away three weeks after the surgery.

  • A jury awarded his family $8.3 million for medical bills, funeral expenses, and wrongful death

In May 2019, Zesis Karavas was 53 when he had surgery at the University of Maryland Medical Center in Baltimore, Maryland. Karavas was scheduled to have his left kidney removed. During the procedure, surgeons accidentally perforated Karavas’s bowel. Karavas died three weeks later. His medical records show his cause of death as colon perforation and multiple organ failure. In March 2024, a Maryland jury ruled in favor of the surviving members of Karavas’ family, awarding them $8.3 million.[]

Karavas needed the surgery to remove a growth on his left kidney. Records show that the surgery initially began as a laparoscopic procedure but had to be converted to an open surgery. Surgeons Talal Al-Qaoud, MD, and Naeem Goussous, MD, performed the procedure. According to the complaint documents, neither physician immediately recognized Karavas’ bowel perforation. 

After the perforation 

Karavas began experiencing low blood pressure after surgery. Records show that an odor was also coming from his surgical drain. A second exploratory surgery was done the following day. By this point, patient notes show that doctors suspected a bowel injury. During surgery, a 1-centimeter hole was found in Karavas’ colon. 

In Karavas’s medical records, it’s noted that this perforation is “probably missed from blunt injury from an instrument.” A portion of Karavas’ colon was removed during the second surgery. Karavas then remained in the hospital for three weeks before passing away on July 22, 2019. 

Karavas was married and had an adult son. He is also survived by both of his parents. In 2022, his family members brought a medical malpractice suit against the University of Maryland Medical Center, Dr. Al-Qaoud, and Dr. Goussous.[] 

Bringing the case to trial 

In March 2024, a Baltimore City Court heard the case. After eight days of trial, the jury ruled in favor of the Karavas family and awarded them a total of $8.3 million: $6 million was awarded for wrongful death and split among Karavas’s wife, adult son, and parents. Another $2.3 was assessed for damages, such as medical bills and funeral costs. 

However, Maryland has a $1.3 million cap on non-economic damages. This will reduce the wrongful death portion of the award. A final award amount has not been released. 

Speaking to the press, Karavas family legal representative Emily “E.J.” Hammann, a partner at Brown & Barron LLC, said:

“Our clients are grateful that the jury listened carefully to all of the evidence and held the defendants accountable for the loss of their husband, father, and son.”

Speaking for the University of Maryland Medical Center, Tiffani Washington, Director of Media Relations, said:

“We recognize that the Karavas family suffered a tragic loss, and this case understandably evoked a strong emotional response. Although we respect the jury’s verdict, we very much stand by the care delivered by our dedicated physicians and health care team.”

The non-economic damages cap in Maryland

Maryland is one of several states in the country that cap noneconomic damages in medical malpractice cases. The state first set an initial cap of $650,000 in 2005.[] Since then, the cap has risen by $15,000 each year. In 2024, the base cap is  $950,000.[] However, Maryland allows 125% of the cap to be reached in cases with more than one claimant or beneficiary.[] This means that in cases such as the Karavas family's, the cap rises to $1.3 million.

The conversations surrounding malpractice caps

Currently, about 30 states have some sort of malpractice cap in practice. These caps are often controversial. Laws creating new caps, reduced caps, and increased caps have been seen nationwide in the past several years.  

The effect of caps on insurance premiums is a frequently debated point. It’s often stated that caps can help keep premiums low and can allow states to attract and keep more qualified physicians. However, some data has suggested the effect of caps on premiums is minimal.

A recent study conducted by actuaries for large medical malpractice companies has argued that caps could have another benefit.[]

Massive awards in malpractice cases are becoming more common. There are many factors tied to this rise in large verdicts. One is social inflation, a phenomenon that’s affected many industries that serve the public. Malpractice cases have seen a rise that can be linked to social inflation, but the increase is small when compared to verdicts in other cases involving human life, such as auto insurance claims. 

The actuarial study looked at data from across the country and concluded that malpractice caps could be a key factor behind social inflation’s more minor impact on healthcare costs. Discussing this effect, the authors stated: 

“Restrictions on noneconomic damages in medical malpractice may be mitigating social inflation. [...] States that relax caps or remove them are likely to realize sharp rises in claim severity as well as a change in the variety of medical malpractice claims.”

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