Man suffered permanent spinal cord damage after surgery — $4M verdict

Type of action: Medical malpractice

Injuries alleged: Spinal cord injury

Name of case: Wolfe v. Lim, M.D. and Atlantic Brain & Spine, LLC

Court: Fairfax County Circuit Court

Case no.: CL2018-10069

Tried before: Jury

Name of judge or mediator: Judge Michael F. Devine

Date resolved: 10/19/2022

Demand: $1,850,000

Verdict or settlement: Verdict

Amount: $4,000,000 (with interest)

Attorneys for plaintiff (and city): Anthony M. “Tony” Russell, Roanoke; Les S. Bowers, Charlottesville

Russell

Description of case: David Wolfe, a 58-year-old male, presented to Dr. Jae Lim with mid-thoracic pain and bilateral leg weakness with associated balance issues and difficulty standing and walking. An MRI revealed a T9-10 disc herniation which had caused compressive thoracic myelopathy. Dr. Lim recommended surgical intervention that he termed a “modified or combined posterior/costotransverse approach” with interbody fusion and insertion of pedicle screws as needed. The spine surgery was performed at Reston Hospital Center utilizing neuromonitoring.

During the initial part of the decompression, Wolfe’s motor evoked potentials and SSEPs were lost completely with reportedly partial return approximately 10 minutes later. After the loss of neuromonitoring signals, Dr. Lim continued to proceed with the bilateral diskectomy and decompression along with the fusion. Postoperatively, Wolfe had almost no movement in his legs. Due to his paralysis, he was transferred to the intensive care unit. A postoperative MRI of the thoracic spine showed cord signal change consistent with an intraoperative injuryand severe canal stenosis with cord compression at the T9-10 level, despite the surgery.

Dr. Lim improperly performed the surgery by taking a straight posterior approach (i.e., laminectomy) when he should have taken a lateral or anterior approach. This negligence resulted in Wolfe suffering permanent damage to his spinal cord.

Wolfe never recovered sensation or motor function in his lower extremities, bowel or bladder. He was discharged home after a short stay in inpatient rehabilitation. At home, he was unable to access any room but the living room. As such, the family converted the living room into his living quarters. He cannot go upstairs or downstairs and cannot fit into any of the bathrooms in the house with his wheelchair. His wife, who was trained as an attorney and works in nonprofit public health for seniors, performs all of his care including changing his adult diapers, emptying his suprapubic catheter bag and giving him sponge baths.

Plaintiff’s two orthopedic spine surgeons testified that Dr. Lim (a neurosurgeon) did not perform his self-termed “modified costotransversectomy” (which is a lateral/posterolateral approach) but that he instead performed a mere laminectomy (posterior approach). They explained with references to about a dozen pieces of designated literature dating back to the late 1800s that a laminectomy alone was absolutely contraindicated for thoracic disc herniations because the approach does not permit the surgeon to be lateral enough to avoid injury to the spinal cord. They testified that Dr. Lim’s approach (in which he removed only the lamina and part of the facet joint) was a forbidden posterior approach.

Bowers

The defense designated no literature. Instead, the defense argued that a surgeon could “modify” any surgical procedure to his liking, and that Dr. Lim did not violate the standard of care and did not touch or injure the spinal cord.

No medical bills, lost wages or future lost earnings were introduced. Counsel elected during trial not to call a life care planning expert. The only special damages put before the jury came in the form of testimony from the plaintiff’s wife regarding her knowledge of certain medical bills, transportation expenses and necessary home modifications.

After approximately four hours of negotiations, the jury returned with a verdict of $4 million plus interest from the date of the malpractice, which was exactly the amount requested in both opening and closing. The trial court entered judgment for the plaintiff in the amount of the applicable medical malpractice cap of $2.25 million with interest from the date of the verdict. Plaintiff’s law firm provided case information.