This case takes place in Connecticut and involves an elderly male patient who was in good health and living independently. On one occasion, the man suffered a serious fall while walking in the park, and was transported by ambulance to his local hospital. While in the hospital, the man was diagnosed with a neck fracture, however there was no evidence of weakness or loss of sensation in any of the man’s extremities. In order to operate on the patient’s injuries, doctors unsuccessfully attempted to administer spinal anesthesia multiple times before reverting to general anesthesia for the procedure. The orthopedic surgeon then proceeded to perform surgery on the patient, which occurred without incident. In the hours following the surgery, the patient was seen by doctors twice, though no examination of his extremities was noted. Eventually, it was discovered that the patient was having difficulty moving his fingers and toes. Over the course of several days, the patient was seen by multiple other physicians, all of whom were allegedly not informed of the multiple attempts at spinal anesthesia by the operating orthopedist. It was eventually determined that revision surgery would be necessary to treat the damage to his spine. Over the course of the patient’s treatment, he claims that he experienced numbness and immobility at all times, and that doctors were aware of the severity of his injuries but allegedly attempted to downplay the damage caused by the initial anesthetic application. It is claimed that the delay he experienced between his initial injury and revision surgery greatly reduced his potential for recovery, and he has since had to pay extensive medical fees in order to pay for locomotive training and physical therapy.
Question(s) For Expert Witness
- 1. In your opinion, where were the major points of failure and negligence in this patient's care?
Expert Witness Response E-007022
Extreme caution is warranted in a situation like this where there were several failed attempts at obtaining spinal anesthesia which would obviously increase the risk of developing serious injuries. Clearly, I think the degree of vigilance postoperatively was less than optimal given the fact that this patient’s condition was undiagnosed for a week during which time his neurological deficits were left untreated, which I feel contributed to his current situation. Certainly, I think the postoperative care was inadequate, including the fact that a physical examination with assessment of his neurologic function, was not performed on several occasions even after the patient was noted to have weakness in his extremities. in addition, it certainly seems as if the staff and covering physicians were not informed about the failed attempts to obtain spinal anesthesia and the subsequent risk of spinal injury with the accompanying loss of function. Given the natural history of these types of neural injuries, I think the duration of time during which these injuries went untreated likely contributed to severity of his condition, and limited his potential for any neurologic recovery.