Plaintiff, 86, married and the mother of seven, presented to the defendant orthopedic spine surgeon in January 2013 with complaints of gait difficulties and imbalance. MRIs of her spine revealed severe spinal canal stenosis (narrowing) and spinal cord compression in her cervical spine (levels C4-5 and C5-6) and in her thoracic spine (Levels T10 and T11). The stenosis in her thoracic spine was due to an extremely rare condition: ossification of the posterior longitudinal ligament. In OPLL, the posterior ligament running vertically along the front of the spine becomes calcified and compresses the spinal canal and spinal cord, causing lower leg symptoms. If not surgically decompressed, OPLL can lead to the inability to stand and walk. Hesitant to operate on the OPLL in plaintiff’s thoracic spine, the defendant first operated on her neck in February 2013 in an attempt to relieve her symptoms. The surgery did not relieve her leg symptoms. In October 2013, the defendant operated on plaintiff’s thoracic spine. The defendant used a posterior-lateral approach to remove the bony elements in the back of her spine and then removed a small portion of the ossified ligament, which he could access. When the patient awoke in the recovery room, she was paraplegic. She remains paraplegic, incontinent of bowel and bladder, and has suffered through painful sacral ulcers, months of rehabilitation and hospitalizations ever since the October 2013 surgery.
Plaintiff sued her spine surgeon, claiming that because of his faulty posterior approach and shoddy technique, he manipulated the spinal cord at surgery and caused her paralysis. Plaintiff’s experts testified that the defendant should have approached the OPLL from the front or side notwithstanding the fact that those approaches are longer, more complicated surgeries which require collapsing a lung, removing a rib and moving her calcified aorta, among other things. Plaintiff’s experts claimed that the defendant’s posterior approach was doomed to fail because it provided only limited access to the OPLL and forced him to move/manipulate the spinal cord to reach the OPLL. A post-op MRI of the region showed edema inside the spinal cord – a telltale sign of surgical trauma according to plaintiff’s experts. The defense theme was that defendant elected a reasonable, less invasive posterior-lateral approach, not a pure posterior approach, because of the patient’s advanced age and the morbidities associated with the frontal or lateral approaches. Defendant also denied touching the spinal cord and claimed that the post-op imaging was not conclusive as to the cause of injury. In closing arguments, plaintiff stressed that the plaintiff walked into the hospital and came out a paraplegic.
After four-and-a-half days of evidence, the jury deliberated for about five hours before returning a defense verdict.[15-T-153]
Type of action: Medical malpractice
Injuries alleged: Paraplegia following back surgery
Court: Fredericksburg Circuit Court
Case no.: CL-14-622-00
Tried before: Jury
Judge: Patricia Kelley
Date resolved: Oct. 8, 2015
Special damages: $480,000 in past and future medical bills
Verdict or settlement: Defense verdict
Attorneys for defendant: Byron J. Mitchell and Coreen A. Silverman, Fredericksburg
Defendant’s experts: Thomas Gleason, M.D., orthopedic spine surgeon, Chicago; Allen Maniker, M.D., neurosurgeon, New York; Stuart Fruman, M.D., radiologist, Reston
Plaintiff’s experts: Tushar Patel, M.D., orthopedic spine surgeon, Bethesda, Maryland; Greg Graziano, M.D., orthopedic spine surgeon, Detroit; Jeff Poffenbarger, M.D., neurosurgeon, Cody, Wyoming; Rajesh Bhojwani, M.D., Washington, neuroradiologist; Charles Beamon, M.D., Fredericksburg, urologist
Insurance carrier: The Doctor’s Company