Medical Expert Witness & Consultant Group
Topic: Brain tumor surgery
Example 1:
A young man suffering from visual disturbances underwent CT-scanning and a benign tumor was detected in the posterior region of the brain. When the brain was exposed for surgical removal of the tumor, the surgeon did not find a tumor in the right brain hemisphhere as was indicated on the CT-scan. Incisions were made into the healthy brain without success. Finally, it occurred to the surgeon to use the ultrasound imaging device available in the operating room to find the tumor. It was discovered in the opposite hemisphere because the radiological technician had erroneously exchanged "left" and "right" in the CT-scanner, causing the surgeon to operate erroneously on the right brain hemisphere. When the surgeon saw himself confronted with this situation, he tried to remove the tumor from the side of his opening. This procedure induced further damage to the brain in both hemispheres and left the patient with a residual tumor, which had to be excised in a second operation by exposure of the other brain hemisphere. Already after the first operation, the patient's vision dramatically deteriorated to complete blindness on one side and minor residual vision on the other side. The young man was thus left physically handicapped to a high degree, with practically no chances for his further education and later profession.
Legal proceedings filed against the surgeon by the parents at district court level were unsuccessful for the plaintiff in all instances. According to statements of the expert witness in court, the surgeon could not be made responsible for not discovering the mistake of the radiologist; moreover, the use of ultrasound imaging in the operating room was determined to be advisable, but not required. Thus, the damaging brain incisions were stated as being unavoidable in order to detect and remove the tumor, as indicated on the CT-scan. Finally, the attempt to remove the tumor from the wrong side was described as being justifiable, since the patient was under anesthesia and the skull was opened with the brain exposed.
When our expert got involved at state court level, the situation changed; it became apparent, that 1. the preoperative visual disturbance, which was the patient's initial symption, was in contradiction to the (wrong) CT-image (left brain hemisphere is responsible for vision). Hence, it was necessary to perform preoperative control imaging (which would have uncovered the error of the first radiologist); 2. intraoperative ultrasound imaging was a standard practice at the time of surgery, its use was mandatory especially because it was readily available. Not to use it in a timely manner was seen as the cause of avoidable brain damage on the healthy side of the brain; 3. surgery from the wrong side, at the cost of brain function in both hemispheres, was seen as negligence.
The case was successfully won by the patient and he received full compensation for the damages.
