A Muscatine County family that last year sued Iowa City-based ENT Medical Services and one of its otolaryngologists after a 2-year-old died following a routine procedure to put tubes in his ears and remove his adenoids has added a third defendant to its lawsuit: the state of Iowa, for its oversight of the University of Iowa Hospitals and Clinics.
“Through the course of discovery, information relating to an additional potentially liable party has come to the plaintiffs’ attention,” according to a Friday amendment to the petition that the estate of Louden Lofgren first filed in February 2022.
The amendment hinges on allegations a UIHC resident was involved in the child’s operation — without informing or receiving consent from the family.
“Dr. Ryan Smith’s performance of the April 2, 2021 adenoidectomy on Louden Lofgren without identifying himself or obtaining permission from Maggie Lofgren to operate on her son constituted a medical battery,” according to the amended lawsuit.
The toddler — which, according to posts from the Muscatine Republicans on social media, is the grandson of state Sen. Mark Lofgren, R-Muscatine — went in for tube placement in both ears and an adenoidectomy in April 2021 at the Iowa City Ambulatory Surgery Center. According to the lawsuit, Thomas Simpson, an otolaryngologist and chair of the Iowa City Ambulatory Surgery Center’s board of directors, was the “primary surgeon” for the procedure — with assistance of Smith, a fourth-year medical resident.
Toward the end of the adenoidectomy, “very brisk bleeding” began, requiring quick action to control, according to the lawsuit. After the bleeding appeared to have been resolved, and as the child was waking up, bleeding resumed along with coughing — filling his oral cavity, according to the family’s lawsuit.
With labs showing anemia and low hemoglobin levels — among other issues — Louden was transferred and admitted the same day to Mercy Iowa City, where he received a partial blood transfusion, according to the lawsuit. At discharge, on April 4, 2021, he still had an increased heart rate and did not receive a repeat check of his hemoglobin following the transfusion, the family reported.
Nursing documentation from the operating room indicated UIHC resident Smith was “at the head of the bed when the intraoperative bleeding began,” and Simpson was at the head of the bed to resume the operation two minutes later, according to both the original and amended lawsuits.
“Dr. Simpson’s note reads as if he was the primary surgeon for the entirety of the procedure and does not identify who was operating on Louden when the hemorrhage began,” according to both versions of the lawsuit.
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The amended lawsuit adding the state as a defendant notes Smith — at no time before the surgery or after — introduced himself to the child’s mom or identified himself as a medical resident who would be performing part of her son’s surgery.
“Prior to Louden’s surgery, Maggie Lofgren was not informed and was not otherwise made aware that Dr. Smith, a medical resident, would be performing any portion of the surgery,” according to the updated lawsuit.
While an inpatient at Mercy Iowa City, Simpson “made no effort to follow up and determine the source of the significant and excessive bleeding,” according to the family, which reported taking him within 24 hours of his Mercy discharge to the UIHC emergency room where he was “pale” and “listless.”
The child was admitted to UIHC for dehydration and symptomatic blood loss and received a blood transfusion, stabilizing him until he was discharged April 7, 2021. Five days later, while at home eating dinner, Louden began to hemorrhage and go into cardiac arrest, according to the lawsuit.
“He was emergently taken to Trinity Hospital in Muscatine and then transferred to UIHC, where drastic efforts to save him were unsuccessful and he passed away shortly thereafter,” according to the lawsuit, noting he was 2 years old when he died.
In new allegations, the family accused the resident Smith of failing to obtain informed consent “prior to performing the adenoidectomy portion of the surgery on Louden.”
“Defendant State of Iowa is vicariously liable for the negligence and battery of its employees, physicians, residents and others who may have been involved in the care of Louden Lofgren, including Ryan Smith,” according to the amended lawsuit, which seeks damages for medical bills, losses from the premature death and compensation for pain and suffering.
The lawsuit reports the family filed claims March 23 with the State Appeal Board but that “after more than six months of inaction by the State Appeal Board, said claims are considered denied.”
In previous court documents, Simpson and ENT have denied many of the allegations — including those alleging pain and suffering, medical expenses and deprived earnings. Defendants said they have “insufficient information to admit or deny the allegations” against Smith and therefor deny them.
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“Through the course of discovery, information relating to an additional potentially liable party has come to the plaintiffs’ attention,” according to a Friday amendment to the petition that the estate of Louden Lofgren first filed in February 2022.
The amendment hinges on allegations a UIHC resident was involved in the child’s operation — without informing or receiving consent from the family.
“Dr. Ryan Smith’s performance of the April 2, 2021 adenoidectomy on Louden Lofgren without identifying himself or obtaining permission from Maggie Lofgren to operate on her son constituted a medical battery,” according to the amended lawsuit.
The toddler — which, according to posts from the Muscatine Republicans on social media, is the grandson of state Sen. Mark Lofgren, R-Muscatine — went in for tube placement in both ears and an adenoidectomy in April 2021 at the Iowa City Ambulatory Surgery Center. According to the lawsuit, Thomas Simpson, an otolaryngologist and chair of the Iowa City Ambulatory Surgery Center’s board of directors, was the “primary surgeon” for the procedure — with assistance of Smith, a fourth-year medical resident.
Toward the end of the adenoidectomy, “very brisk bleeding” began, requiring quick action to control, according to the lawsuit. After the bleeding appeared to have been resolved, and as the child was waking up, bleeding resumed along with coughing — filling his oral cavity, according to the family’s lawsuit.
With labs showing anemia and low hemoglobin levels — among other issues — Louden was transferred and admitted the same day to Mercy Iowa City, where he received a partial blood transfusion, according to the lawsuit. At discharge, on April 4, 2021, he still had an increased heart rate and did not receive a repeat check of his hemoglobin following the transfusion, the family reported.
Nursing documentation from the operating room indicated UIHC resident Smith was “at the head of the bed when the intraoperative bleeding began,” and Simpson was at the head of the bed to resume the operation two minutes later, according to both the original and amended lawsuits.
“Dr. Simpson’s note reads as if he was the primary surgeon for the entirety of the procedure and does not identify who was operating on Louden when the hemorrhage began,” according to both versions of the lawsuit.
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The amended lawsuit adding the state as a defendant notes Smith — at no time before the surgery or after — introduced himself to the child’s mom or identified himself as a medical resident who would be performing part of her son’s surgery.
“Prior to Louden’s surgery, Maggie Lofgren was not informed and was not otherwise made aware that Dr. Smith, a medical resident, would be performing any portion of the surgery,” according to the updated lawsuit.
While an inpatient at Mercy Iowa City, Simpson “made no effort to follow up and determine the source of the significant and excessive bleeding,” according to the family, which reported taking him within 24 hours of his Mercy discharge to the UIHC emergency room where he was “pale” and “listless.”
The child was admitted to UIHC for dehydration and symptomatic blood loss and received a blood transfusion, stabilizing him until he was discharged April 7, 2021. Five days later, while at home eating dinner, Louden began to hemorrhage and go into cardiac arrest, according to the lawsuit.
“He was emergently taken to Trinity Hospital in Muscatine and then transferred to UIHC, where drastic efforts to save him were unsuccessful and he passed away shortly thereafter,” according to the lawsuit, noting he was 2 years old when he died.
In new allegations, the family accused the resident Smith of failing to obtain informed consent “prior to performing the adenoidectomy portion of the surgery on Louden.”
“Defendant State of Iowa is vicariously liable for the negligence and battery of its employees, physicians, residents and others who may have been involved in the care of Louden Lofgren, including Ryan Smith,” according to the amended lawsuit, which seeks damages for medical bills, losses from the premature death and compensation for pain and suffering.
The lawsuit reports the family filed claims March 23 with the State Appeal Board but that “after more than six months of inaction by the State Appeal Board, said claims are considered denied.”
In previous court documents, Simpson and ENT have denied many of the allegations — including those alleging pain and suffering, medical expenses and deprived earnings. Defendants said they have “insufficient information to admit or deny the allegations” against Smith and therefor deny them.
Family of boy who died after adenoids surgery adds state to lawsuit
The Muscatine County family that last year sued Iowa City-based ENT Medical Services and one of its otolaryngologists after a 2-year-old died following a routine procedure to put tubes in his ears have added a third defendant to its lawsuit: the State of Iowa – for its oversight of the...
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