LEFT BEHIND A medical malpractice suit against 2 surgeons who allegedly left behind a ligating clip during prostate removal surgery may proceed.

When doctors removed a large bladder stone that was causing a patient's abdominal pain, incontinence and infection after robot-assisted prostate removal, they made a shocking discovery — a ligating clip that had somehow burrowed its way inside the stone.

The retained object is at the center of a medical malpractice suit the patient filed against his 2 surgeons — a case that an appellate panel reopened last week after it had been dismissed originally.

But how did the clip get inside the stone? A urologist testifying as an expert witness on behalf of the defendant has a theory. The clip that had been inserted during the robotic-assisted laparoscopic radical prostatectomy traveled to the bladder when the bladder neck was open during the procedure, and had not been located or retrieved before closure, says Thomas E. Kasper, MD.

The patient, Jeffrey Chandler, felt ill for 18 months after the 2012 prostate removal, according to the complaint. A cystoscopy revealed a large bladder stone. The suit says surgeons Steven Chang, MD, and Daniel Welchons, MD, failed to properly apply the clip, recognize that it had become loose, or retrieve the clip before closing the patient's bladder. The urologists point out that radiologists failed to detect the clip on CT scans.

The doctors' attorneys did not respond to requests for comment.

Brielle Gregory