Jury clears neurosurgeon of malpractice in connection with postoperative complications following Chiari I malformation surgery.

A 24-year-old Staten Island woman underwent surgical repair of a Chiari I malformation by the defendant neurosurgeon. Nine days after the original surgery, defendant performed a second procedure, a duraplasty repair to correct cerebral spinal fluid (CSF) leak and pseudomeningocele. Six weeks later, the plaintiff left the defendant's care and underwent placement of a ventriculo-peritoneal shunt (brain to abdomen) and additional repair and decompression surgery by a different neurosurgeon for recurrent CSF leak and a large pseudomeningocele which extended from the base of the skull to the 5th cervical vertebra.

Plaintiff contended that the defendant was negligent in failing to recognize increased intracranial pressure following the initial surgery and in failing to place a lumbar drain which would have allowed the repair to be successful. Plaintiff further claimed that the defendant failed to perform additional necessary surgery when it was evident the repair had failed and CSF continued to leak. Plaintiff claimed to suffer from chronic neck pain, weakness and limited range of motion as a result of the multiple surgeries and pseudomeningocele. Plaintiff claimed permanent inability to work, and sought damages in excess of $3 million for pain and suffering, and $1.5 million for lost earnings. A treating pain management physician and treating physical therapist were called as witnesses on plaintiff's behalf. The plaintiff wore a hard neck collar throughout the trial, and claimed to wear it always secondary to pain and weakness.

Our jury accepted the defense position that placement of a drain was not necessary in the absence of evidence of increased intracranial pressure, and that defendant neurosurgeon did not depart from accepted standards of medical practice in not performing a shunt and revision surgery during the four weeks which followed the repair. Defendant also asserted that plaintiff's subsequent neurosurgeon was over-aggressive in his surgical approach.