Iowa City surgeon sued after child dies following adenoids surgery

An Iowa City parent is suing otolaryngologist Thomas Simpson for negligence after a 2-year-old died following an adenoid procedure. Fourth-year University of Iowa medical resident Ryan Smith assisted in the surgery and is named in the lawsuit.


Kate Perez and Cooper Worth, News Reporters

An Iowa City parent is suing a surgeon after their 2-year-old died following a procedure to remove his adenoids. The otolaryngologist was assisted by a University of Iowa medical resident.

On April 2, 2021, Louden Lofgren was brought to the Iowa City Ambulatory Surgery Center by his parents, where he underwent a bilateral tympanostomy with tube placement and adenoidectomy, performed by ENT Medical Services otolaryngologist Thomas Simpson.

Lofgren is the grandson of state Sen. Mark Lofgren of Muscatine, Iowa, according to a Facebook post by the Muscatine Republicans.

Simpson was assisted by Ryan Smith, a fourth-year medical resident in the UI Carver College of Medicine.

Toward the end of the adenoidectomy portion of the procedure, Louden began bleeding as additional adenoid tissue was allegedly removed, and gauze was placed with pressure to control bleeding, according to the lawsuit filings.

According to lawsuit filings, after the bleeding had “apparently” resolved, Louden woke up and he began to cough and bleed in his mouth.

Additional pressure was applied to the gauze and an IV was placed, and labs taken showed Louden’s anemia and hemoglobin levels were down to 6.5, below the 12.5 average.

According to documentation from nurses on shift, medical resident Smith was at the head of the bed when Louden began bleeding, and two minutes later Simpson was at the head of the bed to resume the operation.

“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 Lofgren when the hemorrhage began,” the lawsuit alleges.

Louden was then transferred to Mercy Iowa City, where he was admitted due to an accelerated heart rate and low blood levels. While at Mercy, he received a partial blood transfusion and two days later was discharged.

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There was no repeat check of his hemoglobin after Louden’s transfusion, the lawsuit alleges.

Within 24 hours of discharge, Louden was rushed to the University of Iowa Hospitals and Clinics emergency room by his parents, with a notable history “of low hemoglobin and black stools,” according to lawsuit filings. Medical staff assessed him as “listless” and “pale”, and he was admitted due to blood loss and dehydration.

While an inpatient at UIHC, Louden received a blood transfusion due to dropping hemoglobin levels, which improved following the transfusion. He remained stable for the remainder of his hospital stay until he was discharged on April 7, 2021, according to the lawsuit.

Five days later, on April 12, Louden began to hemorrhage while eating dinner, and went into cardiac arrest. He was rushed to nearby Trinity Hospital in Muscatine, Iowa, and then transferred to UIHC, where he died shortly after.

The source of Louden’s hemorrhaging on April 12, 2021, was found to be from Louden’s left pharynx, the surgical site where the original bleeding occurred during the adenoidectomy performed ten days prior by Simpson.

Charles Myer, a licensed physician in Ohio and Kentucky who practices medicine in the same area of otolaryngology as Simpson, is cited in the lawsuit’s certificate of merit in the plaintiff’s defense.

“Based upon my review of these medical records, I hereby certify, to a reasonable degree of medical certainty, that Thomas Simpson, M.D., breached the standard of care with respect to the care provided to Louden Lofgren on April 2, 2021, and thereafter,” Myer wrote.

The family states in the lawsuit they seek damages for various acts against Louden including:

  • Severe conscious mental and physical pain and suffering
  • Medical experiences incurred for the care and treatment of Louden
  • Interest on premature incurred expenses for his funeral and burial

The lawsuit also states what the family has been deprived of since Louden’s death, including the expected accumulations had he lived to his normal life expectancy, and the loss of his care, society, services, companionship, contributions, consortium, and support for his mother.

Overall, the lawsuit accuses Simpson of being negligent in the following:

  • Properly monitoring and consultation on the patient with significant and excessive intra-operative bleeding
  • Obtaining or ordering diagnostic testing, imaging studies, or otherwise investigating following significant and excessive intra-operative bleeding
  • Appropriately and adequately documenting a history of significant and abnormal intra-operative bleeding and related findings to subsequent care providers
  • Obtaining a proper and complete history prior to the surgical procedure and informed consent
  • Permitting a medical resident to perform surgery without the patient’s consent
  • Providing care and treatment consistent with applicable standards of medical and surgical care

The lawsuit states that ENT Medical Services are “vicariously liable” for the negligence of its employees and those who may have been involved in the care of Louden, including Simpson.

“Louden Lofgren’s death and resulting damages are within the scope of Defendants’ liability and said injuries and damages arose from the same general types of danger that said Defendants should have taken reasonable steps to avoid,” it states.

The attorneys representing Simpson and ENT answered by denying all allegations claiming they were responsible for Louden’s death and the accusations of negligence.

The answer also states there is “insufficient information to admit or deny the allegations” regarding who was operating on Louden when the hemorrhaging began but admitted Smith was assisting with the surgery.

The trial’s scheduling conference will take place on May 3 at 10:30 a.m. at the Johnson County Courthouse, according to court documents.

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