Vascular Surgery Leads To Paralysis and $1 Million Settlement in Medical Malpractice Lawsuit

2020 Medical Malpractice Case Report
By Attorney Nicholas D. Cappiello

Lawsuit claims surgeon should not have performed both abdominal aortic aneurysm repair and aorto-femoral bypass in the same surgery

A 65-year-old woman became paralyzed after undergoing major vascular surgery performed by the defendant surgeon. The plaintiff’s past medical history included peripheral artery disease, congestive heart failure, hypertension, diabetes, hyperlipemia, renal failure, severe COPD with supplemental oxygen, obesity, chronic neck and back pain, asthma, stress incontinence with surgical placement of a bladder sling, and a history of smoking.

In 2013, the plaintiff presented to the defendant surgeon for evaluation of a 3.8 cm abdominal aortic aneurysm (“AAA”) that had been found incidentally on an MRI for back pain. During the work-up, the defendant surgeon also discovered severe peripheral vascular disease. A CT angiogram revealed that the plaintiff’s right common iliac arteries were completely occluded, and she had severe stenosis of the proximal left superior femoral artery, which was completely occluded at the left mid-thigh.

Defendant surgeon recommended that the plaintiff undergo surgery to address both the blockages in her arteries and the AAA at the same time because future AAA repair would be more complicated in the presence of the earlier bypass repair. Thereafter, the plaintiff agreed with the plan and underwent an open aorto-iliac/femoral bypass surgery to repair the AAA and to bypass the blockages in her arteries.

Post-operatively, the plaintiff did well for the first 24 hours with blood pressures within the normal range and normal strength and normal motor and sensory responses in her legs. The following morning, she was noted to be up out of bed and walking around her hospital room. However, she later woke up from a nap and was unable to feel or move her legs.

The defendant surgeon ordered a STAT spinal MRI, which showed a new acute infarction in the plaintiff’s spine since her surgery. She remained hospitalized for several weeks, during which time the cause of her spinal stroke was never determined. Unfortunately, she did not recover and was left with permanent lower extremity paralysis.

The plaintiff’s claim was that the defendant surgeon should not have performed both the AAA repair and the aorto-femoral bypass in the same surgery. Rather the plaintiff contended that the AAA did not need to be repaired at that time and the defendant surgeon should have placed stents to relieve the blockages in the artery rather than perform open bypass surgery. The plaintiff further contended that as a result of the major vascular surgery attempted by the defendant surgeon, the plaintiff suffered a gradual reduction in blood flow to her spine, which ultimately caused the spinal cord stroke the day after surgery. The plaintiff contended that had the defendant surgeon placed stents only, then the blockages in the artery would have been relieved without disrupting blood flow to the spine and more likely than not the plaintiff’s injuries would have been prevented.

The defendants maintained that the defendant complied with the applicable standard of care and that nothing the defendant did or failed to do caused the plaintiff’s injuries. The defense maintained that the defendant surgeon properly recommended and performed the combined surgery, that stenting was not a viable option for this patient based on the pre-operative imaging findings, and that the injuries suffered by the plaintiff were a known risk of major vascular surgery - a risk to which the plaintiff consented pre-operatively. In summary, the defendant argued that the plaintiff had a complicated and extensive vascular disease for which the only treatment was extensive vascular surgery, and that her injuries were not preventable.

The case was settled for $1,000,000.00.

Lubin & Meyer attorneys Andrew C. Meyer Jr. and Nicholas D. Cappiello represented the plaintiff in this lawsuit.

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