This was a 'routine' surgical procedure.
A 'routine' knee replacement.
Done by a well-known orthopedic surgeon.
At a well-known, well-respected New York City hospital.
She needed the knee replacement.
No question about that.
The surgery went exactly as planned.
There were no complications.
There was no excessive bleeding.
There was nothing unusual about the surgery.
As with every knee replacement, this doctor had standing orders about what his patients needed.
Those standing orders were to be followed by the nurses and orthopedic residents; doctors-in-training.
One of the doctor's standing orders was that a drain in the patient's knee was to be attached to a suction device in the recovery room.
The drain was placed in the knee compartment in order to allow fluid to escape.
The suction device was designed to remove any fluid that built up and allow it to escape the knee compartment easily and quickly.
Why, shortly after the patient arrived in the recovery room, did her belly begin getting larger and larger?
Why did this patient now have a surgical emergency in her abdomen?
This made no sense.
She had surgery to her knee.
Why was her belly now creating a surgical emergency?
The answer to her puzzle was not learned until after the patient was rushed back to the operating room for emergency surgery to her belly.