Richmond County Jury Exonerates Neurosurgeon In Suit By Paraplegic

The 56 year-old plaintiff alleged that the defendant neurosurgeon was negligent in planning for and performing minimally invasive surgery upon an osteophyte that was compressing the spinal cord at T7-T8. Plaintiff's motor strength prior to surgery was determined to be 3/5 in the right leg (unable to lift against gravity) and 4/5 in the left leg. Plaintiff awoke from surgery with complete loss of function and sensation of the lower extremities, and loss of bowel and bladder control.

Plaintiff's expert neurosurgeon contended that surgery was performed via an incorrect approach (posterolateral instead of anterior); that surgery was performed at the wrong level (T6-T7, one level above the osteophyte), and failed to accomplish its intended goal of removing the osteophyte. Plaintiff further contended that the defendant neurosurgeon traumatized the cord and that trauma to the cord, combined with a failure to maintain appropriate mean arterial blood pressure, caused his paralysis. Complicating the case for the defense was the defendant neurosurgeon's operative report, which indicated that the pre-operative plan of resecting the T7 rib to gain access to the T7-T8 level was accomplished. Imaging studies confirmed that no portion of the rib was removed. Defendant's operative report also did not document the removal of the T6 lamina, which was actually accomplished and which defendant and defendant's experts asserted was necessary to access the T7-T8 level. The defense was further complicated by the Chief of Radiology's official interpretation of the post-operative MRI, which he said failed to show decompression of the cord or removal of the osteophyte.

Plaintiff's expert neurosurgeon also contended that the defendant was required to discuss the maintenance of mean arterial pressure with anesthesia prior to surgery, particularly in surgery of this nature performed at the "watershed" area of the thoracic spine.

The defense countered that such a discussion was not required. In fact, in prior testimony in another matter plaintiff's expert had conceded that such a conversation was not required where the anesthesiologist and surgeon had worked together before. The defense also asserted that surgery was performed at the correct level, via the safest approach, and that a substantial portion of the osteophyte was removed, as confirmed by the imaging studies.

The defendant and defendant's experts blamed the paralysis and spinal cord injury on the degree of preoperative insult caused by the osteophyte, combined with the sudden re-expansion of the cord during surgery; vibration from the drill used on the osteophyte was given as an alternative explanation. The jury returned a verdict in favor of the defendant neurosurgeon after deliberating for two hours.

This was Mr. Gerspach's 52^nd victory in his last 55 verdicts taken.