On the eve of trial, attorneys Mark W. Tanner and Peter M. Newman obtained a $2 million settlement for a client who suffered permanent injuries as the result of spinal surgery performed by a Philadelphia neurosurgeon.
Plaintiffs alleged that the defendant neurosurgeon was negligent for proceeding with decompression neurosurgery without first obtaining flexion/extension x-rays, which would have revealed the patient’s unstable spondylolisthesis. When the patient returned to the neurosurgeon after the first surgery complaining of weakness and numbness in her right leg, the doctor finally ordered flexion/extension x-rays that demonstrated a grade II anterolisthesis of L4 on L5, which necessitated a second surgery to stabilize the spine with instrumentation (pedicle screws and rods).
Unfortunately, during the second surgery, the neurosurgeon placed one of the pedicle screws grossly out of position such that it breached the cortex of the L5 pedicle, crossing through the spinal canal and crushing nerve roots in its path. Despite complaints by the patient in the recovery room about the onset of severe right leg pain, a spinal fluid leak, and continued complaints of extreme pain, headaches and dizziness during physical therapy and at follow up exams, the neurosurgeon failed to appreciate the damage he had caused.
The patient continued to suffer for almost four months before the doctor performed a third surgical procedure to remove the malpositioned pedicle screw, which he said was “too close to the skin,” and was, therefore, causing the patient’s pain. Of course, instrumentation close to the skin would not have caused the burning in her legs, numbness in her feet, and pain radiating from her low back down her legs, as described by the patient. Plaintiff’s expert was prepared to testify at trial that these complaints are characteristic of a malpositioned screw impinging upon a neural structure.
The third surgical procedure removed the pedicle screws but left the patient in an unfused state with an unstable spine. The neurosurgeon did attempt an uninstrumented fusion with allograft bone; however, that graft fractured and became dislodged, causing further foraminal stenosis and impingement upon the nerve roots, and exacerbating the patient’s neurologic dysfunction.
The patient then went to a new doctor who recommended and subsequently performed bilateral foraminotomies of L4 and L5, posterior lumbar interbody fusion at L4-5, a two level posterior lumbar fixation/fusion from L3-L5 utilizing iliac crest bone graft, pedicle fixation, and cages, all to correct the errors made by the first neurosurgeon.
Plaintiff filed suit against the neurosurgeon and the hospital that had continued to renew his surgical privileges. Plaintiffs were prepared to establish at trial that the hospital knew or should have known of more than 25 medical malpractice actions filed against the neurosurgeon, the majority of which resulted in substantial settlements or verdicts against the doctor. Plaintiff’s hospital administration experts were prepared to testify that the hospital’s credentials committee breached its duty to select and retain only competent physicians, and failed to ensure quality care for hospital patients.
A confidentiality clause in the settlement agreement precludes disclosure of the names of the defendant neurosurgeon and hospital.