Medical Expert Witness & Consultant Group

Topic: Surgical treatment of spinal trauma

Example 1:

An elderly man fell from a tree and sustained an injury to the neck and right shoulder. On admission to the hospital, he was free from neurological deficit and the radiological examination was negative. One week later, during the course of conservative treatment, the patient complained about weakness in the fingers. A CT revealed a leasion of the cervico-thoracic spine and transfer to neurosurgery was initiated. Repeated radiological exams then showed massive luxation fracture and displacement of vertebral bodies with dangerous narrowing of the spinal canal. At that time, the patient suffered from minor weakness according to the spinal segment C8. Surgery was performed immediately. Postoperatively, he was paraplegic and remained so, even after reoperation for increased narrowing of the spinal canal.

Legal proceedings filed against the surgeon at district court level were unsuccessful for the plaintiff. The expert witness in court stated, that diagnosis and treatment during the first week after trauma were adequate. The expert witness further stated that the first operation was correctly planned and performed accordingly. Moreover, the postoperative complication of paraplegia was a typical complication from this absolutely indicated operation.

When our expert got involved at state court level, the situation changed. It became apparent, that 1. diagnosis and treatment during the first week after trauma were grossly negligent; 2. the timing of the operation for spinal stabilization was not chosen on evidence-based grounds; 3. the operation was not performed as planned and the strategy did not follow any of the presently accepted rules in traumatology (wrong choice and order of surgical approaches, no reduction of spinal stenosis, no stabilization), 4. the surgeon himself hinted in the operative report that he had severely traumatized the spinal cord during the operation by penetration with an instrument.

The case was successfully won by the patient and he received full compensation for the damages.