Patients occasionally awaken from surgery and feel like a hand or a foot is on fire. The pain is that bad. Or a limb may be numb – with no feeling or a pins and needles feeling. Or an arm or leg is weak or paralyzed.
All these can be signs that a nerve was damaged in surgery. This could be medical malpractice, but proving the case is often difficult.
There are two basic ways that malpractice can result in a nerve injury in surgery:
- The surgeon has cut, clamped or badly stretched a nerve in the “operative field” without identifying and protecting the nerve. This is sometimes called a “surgical misadventure.”
- A nerve was placed under prolonged pressure and was damaged from losing its blood supply. This is called a positioning error.
Nerves inside the body are not neatly labeled and color-coded, but any competent surgeon knows where they are and how to avoid them, especially the major nerves that control sensation and movement in the arms and legs. Sometimes the surgeon has no choice but to get close to a nerve. If a nerve gets damaged, but the surgeon immediately recognizes the problem and reports it in the dictated “operative report” that all surgeons are required to create immediately after the case, then it’s often hard to make a malpractice case from that injury.
Injuries that aren’t recognized until the patient reports symptoms are a different story. If the operative report fails to describe any steps taken to protect the nerve, and the nerve gets hurt in a way the surgeon doesn’t notice, then the patient often has a good story to tell of the surgeon simply not paying attention.
Every case is fact-specific and will turn on the surgeon’s operative report, any intra-operative imaging studies, and the exact nature of the injury as revealed by later nerve tests (EMG and nerve conduction) and sometimes by efforts of another surgical specialist to do a nerve repair.
Both the surgeon and the anesthetist or anesthesiologist have a duty to position the patient so that the forces of gravity and other pressures don’t cause nerve damage in patients who are immobilized and helpless to protect themselves.
Common nerve injuries from positioning include:
- Damage to the ulnar nerve at the elbow caused by the patient lying on their arm.
- “Drop foot,” often due to sciatic nerve damage in the hip caused by stretching the leg for pelvic surgery. Drop foot means the patient cannot flex the foot up and down. (These cases are often impossible to prove in court.)
- Shoulder nerve damage (in the brachial plexus), which can affect ability to use the hand.
Consult with an Experienced Malpractice Attorney
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