After outpatient surgery, flesh-eating bacteria leads to patient losing her hands and feet

Purple Nikes cap Lisa-Maria Carter’s prosthetic legs as she walks with physical therapist Rebecca Swick during therapy.
Purple Nikes cap Lisa-Maria Carter’s prosthetic legs as she walks with physical therapist Rebecca Swick during therapy.
Published June 22, 2012

TAMPA — In 2010, Lisa-Maria Carter was about to leave for Iraq as an intelligence analyst under contract with the Department of Defense.

But first, the Tampa woman needed outpatient surgery to remove an ovarian cyst. Her surgeon told her she would go home after a few hours.

Instead, she woke up a month later with flesh-eating bacteria attacking her intestines and abdomen, her hands and feet black from lack of circulation and headed for amputation.

Now, at age 46, she lives in a nursing home, where a few steps with prosthetic legs or a simple handshake with a prosthetic arm count as progress. She hopes one day to counsel wounded soldiers and other amputees.

"There are going to be days when you can't pick up a fork and spoon and you want to throw your tray across the room,'' she said Thursday. "But there are more good days than bad.''

She can no longer work. To finance her future, she wants compensation from those she holds responsible for turning her life upside down.

According to a lawsuit Carter filed Thursday in Hillsborough Circuit Court, Dr. Larry Glazerman mistakenly sliced through her small bowel when removing her cyst. Then he sewed her up without noticing the error.

That led to the massive infection, internal damage and limb loss, the suit says. The surgical error was exacerbated by mistakes made by other staff at Tampa General Hospital, according to the suit. Now, the suit says, she needs care from "highly skilled medical personnel 24 hours a day, seven days a week for the rest of her life.''

Glazerman could not be reached for comment. He is director of the minimally invasive gynecologic surgery program at the University of South Florida. He has an active medical license with no record of complaints in Florida, according to the Board of Medicine website.

Tampa General spokesman John Dunn declined to comment, which is the hospital's normal practice with litigation. The suit also names USF, which had no comment.

Tampa lawyer Kennan Dandar, who represents Carter, estimated economic damages at $40 million, after accounting for current medical bills, lifetime care, a driver, help around the house and future procedures and equipment.

"All this for a woman who told her friend to pick her up four hours after surgery and does not leave the hospital until six months later, with no hands or feet,'' Dandar said.

• • •

Necrotizing fasciitis is as gruesome as its nickname — flesh-eating disease. It is rare, with just 500 to 1,500 cases a year, but 20 to 25 percent of victims die.

It can be caused by more than one type of bacteria and can start with surgery, or even a cut or scrape. A young Georgia woman recently contracted necrotizing fasciitis after a zipline fall and has captured the nation's attention as her father chronicles her battles online.

Dandar says his experts say the bacteria can exist harmlessly in the intestinal tract but can lead to infection if the intestine is pierced.

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The day after Carter's cyst surgery, a nurse was helping Carter go to the bathroom when her incision opened, emitting "copious'' amounts of bloody fluid, the suit says, quoting from nursing notes.

Carter's blood pressure was measured at 67 over 48, way below normal. At times, she was incoherent. Tests were ordered, but some were canceled, while the nursing notes describe her as in acute respiratory failure with possible sepsis and organ failure, the suit says.

Nearly three days after the first operation, Dr. Christopher Hults opened Carter a second time, the suit says. His notes say he found the small bowel almost completely sliced through, which he repaired.

He also found dead tissue "consistent with necrotizing fasciitis'' throughout the abdomen, the notes say. He cut it away until he reached what appeared to be healthy tissue — but the fight wasn't over.

Carter's discharge summary shows that she underwent eight operations in 12 days as surgeons tried to stay ahead of bacteria. Parts of her stomach, intestines and muscle were destroyed, the suit says.

Meanwhile, she was given medicine to increase her dangerously low blood pressure. But in the process, the suit says, blood flow to her extremities was constricted.

By March of 2011, treatments had halted the bacteria, but her hands and feet — as well as much of her forearms and lower legs — had to be amputated.

She was discharged after six months, with parts of her intestines in a bag outside her body.

• • •

Carter says she remembers nothing from the first 30 days of her care because she was in a medically induced coma.

She remembers waking up and seeing black hands. She sometimes drove a sports car with black gloves. "I thought. "Why do I have my gloves on my hands?' '''

At her therapy session Thursday, she grasped plastic cones with prosthetic arms and moved with a walker on prosthetic legs fitted with purple Nikes. The prostheses responded to electrical impulses from muscles just below her elbows and knees. The loss of her abdominal muscles, however, makes it even harder for Carter to keep her balance.

She misses her work as an intelligence analyst. She loved figuring out patterns from data and "knowing things other people didn't know.''

She looks forward to visits from her adult son, who lives in New Jersey, and her 4-month-old granddaughter, whom she first met just two weeks ago.

Tampa General is the primary teaching hospital for the University of South Florida, which provide physicians and helps oversee patient care. Florida's sovereign immunity law limits USF's exposure in lawsuits to $200,000, though Carter could seek more from a special act of the Legislature.

Glazerman and Tampa General have no such protection.

Stephen Nohlgren can be reached at