According to a recent study published in The Journal of Arthroplasty,the most prevalent reason primary hip surgery patients file lawsuits is for nerve injury (foot drop). In a recent nerve injury case, the plaintiff was awarded $1.86 million.
On September 27, 2004, the 63 year old plaintiff underwent hip replacement surgery to address her osteoarthritis and avascular necrosis of the hip. During the surgery, an anesthesiologist placed a psoas block in the patient for post-operative patient-controlled pain management, whereby he inserted a catheter in the plaintiff’s psoas muscle in the lumbosacral region.
The next day, a physical therapist noted that the plaintiff had decreased strength in movement of the hip flexors and ankle dorsiflexion, and was complaining of pain. According to a nurse’s testimony, Coumadin, an anticoagulant, was administered on September 28. However, an administration sheet states that it was given at 12 a.m. on the morning of surgery. On September 29, the plaintiff experienced decreased sensation in her lower right extremity and burning in her right heel. A CT scan revealed a small amount of blood tracking ventral to the right psoas muscle. A neurological evaluation on September 30 found right thigh and calf numbness, right foot drop and leg weakness, which was diagnosed as neurapraxia, a disorder of the peripheral nervous system. On October 4, after the plaintiff was discharged to another hospital for rehabilitation, she was diagnosed with denervation of the right sciatic nerve.
The plaintiff alleges that she continues to suffer foot drop and numbness in her right leg, which have caused her to fall. She now requires a leg brace to walk, and modification of her car to enable her to drive.
She filed a lawsuit for medical malpractice, and lack of informed consent, alongside a derivative claim on her spouse’s behalf. She alleges that the defendants departed from the proper standard of care, negligently causing her to suffer extensive bleeding in the area of the lumbar plexus, as well as serious injury and nerve damage. Also, defendants, who failed to inform the plaintiff of the risks and complications associated with the surgery, and the possibility of bleeding due to treatment with Coumadin, lacked informed consent.
The plaintiff’s expert anesthesiology witness stated that plaintiff’s injuries were due to complications resulting from defendants’ negligence. He further stated that during surgery, the defendants inserted a catheter while the plaintiff was on Coumadin, and failed to make sure that the Coumadin was stopped prior to surgery and that the plaintiff was started on Heparin to reverse the anti-coagulant effect of Coumadin. This caused a bleed around the lumbar plexus, also causing a compression injury at the peroneal nerve level which caused the plaintiff’s foot drop. He also stated that the defendants failed to properly position the plaintiff on the operating table, “allowing the blood to pool around the lumbar plexus during and after surgery, proximately causing the plaintiff’s foot drop.”
Defendants and their anesthesiology and orthopedic surgery experts were unable to sway the jury.
