Amount Of Settment $2,000,000.00
Case Summary:
On January 16, 2012, plaintiff, a 41 year old woman, was admitted to the hospital for insertion of an intrathecal catheter and placement of a pain medication pump for long-standing, intractable pain in her left leg caused by an injury suffered at work. The defendant, an anesthesiologist/pain management specialist, was supposed to place a catheter into the plaintiff's spinal canal in order to deliver pain medication directly to the fluid surrounding her spinal cord. During the proper performance of this procedure, neither the catheter nor the introducer needle used to insert the catheter were ever supposed to come into contact with the plaintiff's spinal cord.
Post-operatively, the plaintiff immediately complained of numbness and weakness in both legs. The defendant, who had left the hospital 30 minutes after the procedure, was alerted but did not return until the following day. At that time, he assumed the neurological problems might be as a result of the medication being delivered through the pump and catheter and he ordered the medication amounts be turned down. However, he did not order any studies or request any consults to determine the actual cause of the patient's continuing bilateral leg weakness. The following day, he ordered the medications turned off completely but, again, ordered no imaging studies or medical consults. On the third post-operative day, the defendant finally ordered a neurological consult, which resulted in the plaintiff being transferred emergently to a tertiary care hospital. Immediately after the transfer, a CT myelogram showed that the catheter the defendant had placed had pierced the plaintiff's spinal cord at approximately T11-T12. By the time of arrival at the tertiary care hospital, doctors were concerned that removal of the catheter could cause even more substantial neurological injury. It was eventually removed and the plaintiff was transferred to rehabilitation facility. Despite the best efforts of the rehabilitation facility, plaintiff was left with bilateral paraplegia and little to no sensation from her periumbilical area to her toes.
Plaintiff's anesthesiology/pain management expert opined that the defendant had departed from applicable standards of care by ostensibly inserting the catheter at L1-2, as stated in the defendant's operative report. The well-recognized standards of care at the time and under the circumstances, required the defendant to place the catheter below the end of the spinal cord (the conus medullaris), usually at the L2-3 or L3-4 level, to avoid unnecessary risk of injuring the cord. However, during the defendant's deposition, when confronted with the CT myelogram showing direct catheter entry at T11-12, the defendant admitted that he had placed the catheter at the T11-12, two levels higher than the level referenced in his operative note and three levels higher than the recognized and accepted level. In an effort to explain his actions, the defendant claimed that he had run into "difficulties" inserting the catheter at the L1-2 level, tried one level higher (T12-L1), where he was also unsuccessful, and was then "compelled" to place the catheter at the T11-12 level. Significantly, the defendant acknowledged that he had made no reference whatsoever of these alleged "difficulties", or the actual level of placement, in his operative report, despite the fact that he had dictated the report more than 24 hours after the surgery, when he knew his patient was exhibiting significant neurological problems. Moreover, he failed to record the purported "difficulties" or the actual placement level in any other writing.
After significant and protracted discovery, defense counsel suggested mediation, which was non-productive. However, one month prior to trial, the Trial Court ruled in favor of the plaintiffs with respect to a nearly dispositive pre-trial Motion filed by the plaintiffs, which resulted in the defendant insurer offering the full policy limits of the doctor's insurance coverage one week after the ruling.
