While the defendant obstetrician-gynecologist was performing a laparoscopic tubal ligation on the plaintiff, he inadvertently perforated the small bowel. While the plaintiff did not claim that the perforation itself was negligent, she alleged that the defendant was negligent in not diagnosing it sooner and that the delay necessitated a surgical repair by a general surgeon. The defendant argued that the patient’s post tubal ligation presentation was more consistent with post-operative ileus than a perforated bowel. The defense expert testified that the Veress needle that likely caused the damage did not go all the way through the bowel wall and thus there was no early leakage of bowel contents into the abdominal cavity. Moreover, the plaintiff was afebrile, did not have an elevated white blood cell count, and did not exhibit a surgical abdomen. It was also reassuring that she had had a bowel movement, good urine output and stable vital signs until the third postoperative day, when the perforation was recognized.