liver biopsy gone wrong

Dear Dr.  I hope you can answer some of my questions about my dad.  He went in for a liver biopsy on 5-15-09. It was done by a radiologist while in a ct scan or cat scan. I don't think a radiologist should do this. About an hour or so after while in his room they gave him lunch and he started vomiting. They took him back down for a scan to check for bleeding. None. They wanted to keep him overnight for observation.  By 2:00 am 5-16-09 he was moved to ICU with kidneys shutting down, difficulty breathing, and stomach/back pain. He was put on a ventilator by 5-17-09. Then they did a standard dialasis. We didn't think he was going to make it through the night. On 5-18-09 they decided he was probably suffering from sepsis. He was then transported to another hospital via air care. He has been on a ventilator and a special constant running dialisis machine since 5-18-09. Today, they are going to stop dialisis and start doing regular dialisis 3 days a week. They are going to remove the ventilator tomorrow, 5-28-09, and put in a trach. His kidney #'s went as high as 5.4 on 5-17 and they are now down to 1.8 on 5-28. We were 1st told they clipped a bowel and clotted the bile duct. The story now is they accidentally hit the bile duct which in turn caused the sepsis, organ failure, etc. He is still in intensive care, critical condition, since 5-16-09.  They also drained a liter of fluid off his lungs a few days ago. This fluid is a different bacteria than the bacteria in the blood.
Have you ever heard of this from a liver biopsy? He walked in fine and healthy. I just don't think they are giving us the whole story. Since all this, the biopsy had come back negative.  Yesterday, 5-26, they claim something is still going on with the liver but they don't know what. They think they might want another biopsy if he makes it through all this.
I would just like to know your thoughts as I have no where else to look.  By the way my dad is 67 years old.
Thank you for your time.
Rob.

[Thomas D Schiano, MD]

unfortunately I have seen this in patients who have biliary obstruction and it can seed a bacteremia and septicemia.  I am glad that it sounds like he is getting a bit better but he remains very ill.  does he have cirrhosis and is in need of a transplant?

[ROB446MX]

Thanks for the reply. No, his biaopsy came back negative. Pathologist unsure but thinks maybe scar tissue. They took him off the special dialisis, and he has been running a fever for 2 days of 100-103. now they are doing more cultures to see what is causing fever. They didn't do the trach because of blood thinners for clots developing in leg and left him on ventilator. its been 2 weeks today and physically i can't see much of a change. Dr's claim they "think" he's doing better. Thanks, Rob.

[Thomas D Schiano, MD]

glad to hear that he's a bit better.  cirrhosis can be missed on liver biopsy--sounds like he has some form of chronic liver disease.

[ROB446MX]

Good afternoon Dr. Schiano.  If you read above it will hopefully refresh your memory of the situation. My dad woke up on june 6th. He was under sedation/ceptic shock for 3 weeks. He was alert and getting better for 1 week. his kidney fuction came back and  they were ready to take him off the trache and get him ready for rehab. The only thing that never completely healed was the pancreis. Was still inflamed. He passed away on 6-14. The preliminary autopsy says an artery in the liver burst and that he had Hepatoma. Still waiting on final results. Nobody ever mentioned the liver again. Blood test showd liver guction normal. How did you know he had chronic liver disease? You told me that last month and I didn't believe you. We are waiting to see if it was from cirrhosis or HEP C. Do you think it was biliary obstruction that caused cirrhosis? If it was would it cause bile to leak during a liver biopsy? could duct get nicked during biopsy? It was determined that the sepsis bacteria was bile. I just want to know how you knew. Would you read the autopsy when I get it? I'm sure its going to be confusing. Thanks. Rob.