Surgery Error Resulting in Paraplegia: $2.2M Settlement

2015 Medical Malpractice Trial Report

Paraplegia Following Epidural Placement in Elective Spinal Cord Surgery

The plaintiff is a 66 year old woman who suffered an acute spinal cord injury (puncture trauma) with lower extremity paraplegia following thoracic epidural placement.

The plaintiff underwent an aortobifemoral bypass graft under general endotracheal anesthesia. In advance of the procedure, the defendant anesthesiologist wanted to place an epidural for post-operative pain management. The defendant noted that he was unable to reach the epidural space after two attempts at T9-10 and one attempt at T8-9. He documented that osseous obstruction had prevented him from reaching the space. He then passed an 18 G Tuohy epidural needle to the epidural space at T8-9 via the right paramedian approach with good loss of resistance. He documented that there was no cerebrospinal fluid or parasthesia. He then documented utilizing a 20 G epidural catheter. He removed the needle, applied a sterile dressing, and administered an epidural test dose. He noted that there was no reaction.

The plaintiff contended that she complained of pain and a burning sensation on three separate occasions during the defendant’s placement of the epidural. There was no evidence in the medical records to support that contention.

In the recovery room, the plaintiff was doing well and was noted to have positive pulses in all four extremities. The epidural was removed. Several hours later, it was determined that the plaintiff was unable to move either of her legs. An MRI of her spine was ordered to assess for spinal cord injury. 

The MRI revealed increased signal within the distal thoracic cord extending from T9-T12. It was noted that the plaintiff appeared to have suffered an iatrogenic T9 spinal cord injury from her epidural. After consultation with a neurosurgeon, it was noted that there was unlikely to be any acute intervention which might help regain function.

The plaintiff continued to have bilateral pulses in both feet but no sensory or motor function in her bilateral lower extremities.

The plaintiff claimed that the defendant caused the paralysis by damaging the spinal cord and surrounding structures during placement of the epidural. The defendant contended he complied with the standard of care and that nothing he did was improper, or was in any way related to causing her injury. This unfortunate medical result was a risk of the procedure and was not preventable.

The case settled a week before trial for the defendant’s policy limits plus a payment from the hospital under an apparent agency theory.

Lubin & Meyer attorneys represented the plaintiff in this medical malpractice lawsuit.

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