Expert Witness Case #40
A 53-year-old man suddenly developed severe weakness of the left arm and leg.
He was rushed to the nearby hospital and seen in the ED.
A CT scan revealed a large right MCA infarct.
The patient was given tPA, admitted to the ICU, and had an uneventful night.
The following morning he developed severe hypertension and tachycardia.
A stat MRI was obtained that showed brain swelling.
The ICU consulted the neurosurgery service, and a right decompressive hemicraniectomy was recommended.
He was taken to the OR that afternoon, and a hemicraniectomy with anterior temporal lobe resection was performed.
On return to the ICU, the patient had developed severe right-side deficits in addition to the unchanged left hemiparesis.
The patient returned to the OR about 2 hours later and underwent a right hemicraniectomy.
His condition deteriorated over the next few weeks. He developed pneumonia, septic shock, ischemic bowel, multi-organ failure, and tragically died several weeks later.
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The patient’s family sued the neurosurgeon.
The expert witness opinion is shown below:
The plaintiffs also sued the anesthesiologist.
The lawsuit is ongoing.
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MedMalReviewer Opinion
Wrong-site surgeries are preventable, but continue to happen. They frequently spur medical malpractice lawsuits that are difficult to defend. The surgeon’s best defense is often a quick settlement under their malpractice insurance policy limits.
Naming the anesthesiologist as a defendant is unfair in my opinion. He did not do the surgery and it is not his responsibility to tell a surgeon where to operate.
Being honest with family members about mistakes is important. This is a painful event for all parties. The neurosurgeon is likely devastated by the error and the family lost their loved one. Covering up a mistake will only lead to further harm; honesty is the best policy.
The defense has not laid out any counter-argument yet. I expect that they will argue that the patient was going to have a catastrophic outcome regardless of the wrong-site surgery, and that his death was ultimately inevitable.
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