A BMC Trauma Surgeon on David Ortiz’s Gunshot Wounds

Just how serious are the injuries beloved retired Red Sox slugger David Ortiz (Hon.’17) sustained after being shot in the back at a nightclub in the Dominican Republic?

Tejal Brahmbhatt, a surgeon on the Boston Medical Center (BMC) Level 1 Trauma team that “takes care of the most penetrating injuries” in Boston (about 80 percent of the city’s bullet and knife injuries), has seen plenty of traumatic injuries to the abdominal area over the course of his career. Based on what he’s seen firsthand in the BMC operating room, and on the news reports he’s read about the attack on Big Papi, he has a good idea of what Ortiz is dealing with, since being shot on June 9, 2019.

Brahmbhatt, who is also a Boston University School of Medicine assistant professor of surgery, hasn’t reviewed any of Ortiz’s medical information. But it’s been reported that Big Papi’s gallbladder, liver, and large intestine were injured by the bullet, so Brahmbhatt says Ortiz was struck in the upper right abdomen. “There’s a lot of very dangerous stuff in that area,” he says. “The pancreas [is nearby], and the largest blood vessel goes behind the liver in that area of the abdomen.”

That blood vessel, called the inferior vena cava, carries blood into the heart. “He’s really lucky,” says Brahmbhatt. “If [the bullet had] hit the inferior vena cava, it could have been life ending.”

Brahmbhatt, who says BMC can see multiple gunshot wounds each week, is also part of the newly formed Boston Trauma Institute, which launched in late 2018. Headed by Peter Burke, chief of BMC trauma surgery and a BU School of Medicine professor of surgery, the institute will work with other BMC departments-including emergency medicine, neurology, pediatrics, and orthopedics-to study the factors that lead to trauma and ways to prevent it.

After he was transported to a local hospital in the Dominican Republic, surgeons reportedly made repairs to Ortiz’s liver. They also removed his gall bladder as well as a damaged section of his colon, repairing the severed intestine by surgically connecting the separated pieces. “The right thing was done; it’s now standard of care to reconnect segments of the colon in most cases of penetrating trauma,” Brahmbhatt says. That’s good news for Ortiz, who would have undergone an entirely different procedure had he received the same injury years ago.

“In the old days, everybody would get a colostomy, which is having the colon attached to a hole in the belly wall, with an external bag to collect stool. Then, the colostomy could be reversed in the future. [Ortiz] is fortunate that the appropriate management was done,” Brahmbhatt says, so that he could avoid a colostomy.

Promisingly, Ortiz has made it through the first challenge for someone who has been shot or sustained any penetrating injury to the abdomen.

“Typically people die on the scene or within the first hour,” Brahmbhatt says. Known by first responders as the “golden hour,” it’s the period of time that can determine whether someone will live or die based on how quickly they can get to a hospital. But that doesn’t mean they’re in the clear.

Despite the fact that Ortiz is reportedly taking his first steps out of bed, over the course of the next several weeks, infections can arise that would put him back in danger.

In Ortiz’s case, the risk is that fluids from the repaired colon or other injured organs can leak in the abdominal cavity after surgery. Brahmbhatt says doctors at Massachusetts General Hospital, where Ortiz was transferred for care, will likely be checking his blood to look for signs of an immune response to infection, as well as monitoring to see if he can tolerate food and have normal bowel movements.

“It’s usually the extremely healthy people who have the best recovery,” and Ortiz is “a fairly athletic person, obviously,” Brahmbhatt says.

Although Brahmbhatt isn’t familiar with the clinic in the Dominican Republic that treated Ortiz, in general, he says that “people who go to a [trauma center] that sees a high volume of gunshot injuries are the ones who have better outcomes.”

Seeing a certain volume of patients is actually one of the criteria that determines the rating of trauma centers in the United States. BMC, which he says, “sees an incredibly high volume of gunshot wounds due to geographic location, near areas of interpersonal violence that happen south of Boston,” has the highest-possible rating as a Level 1 center.

Although the Boston Trauma Institute is in its earliest stages, it’s already getting off the ground with initial funding, says Jennifer Tseng, BU School of Medicine professor and chair of the department of surgery and surgeon-in-chief at BMC. “We are starting with seed grants and will be actively recruiting research faculty,” she says.

Their ultimate goal? Tseng says it’s “to find common ground in the prevention and treatment of violence and injury.”

Tseng adds that-like many Bostonians who were present during the Boston Marathon bombings-members of the Boston Trauma Institute were personally inspired by Ortiz’s message after the bombings that this is “our city!” (Ortiz, famously, added some flair to his proclamation.)

“I recall seeing Ortiz out and about, at restaurants like Blue Ginger, interacting with fans,” Tseng says. He’s “a regular guy, a good guy…I pray and believe he’s going to come back from all this stronger than he ever was.”

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