The plaintiff–mother brought suit against her deceased daughter’s neurosurgeon, alleging that his failure to promptly perform surgery to revise her malfunctioning ventricular–peritoneal (VP) shunt caused her death just a few days before her third birthday. The girl’s prematurity at birth and brain hemorrhage had necessitated the placement of the shunt. The defendant had remained her doctor thereafter, monitoring the shunt’s function during office visits and emergency department admissions with head CT imaging.
In November 2014, the child was admitted to the pediatric intensive care unit under his care, with concern to rule out malfunction of the shunt. Serial CT imaging was obtained, and did not appear to show any dangerous accumulation of cerebral spinal fluid within the brain. However, the girl’s lethargy, headache, and elevated blood pressure and heart rate persisted, prompting her neurologist and intensivists to recommend revision of the shunt. The defendant scheduled, but then canceled surgery to revise the shunt when her symptoms improved. Overnight, her condition deteriorated and she developed persistent seizure activity; by the next day, she had evidence of brain death. Defendant took her to the OR where he placed a new shunt. The child passed away several days later.
Plaintiffs’ expert contended that defendant was negligent in delaying performance of what would have been life-saving surgery. He contended that the child was experiencing “pressure waves” from intermittent increased intracranial pressure as a result of shunt malfunction. The defendant, and another neurosurgeon involved in the infant’s care until just prior to the canceled surgery, testified that there was no evidence of shunt malfunction. Defendant identified the cause of death as seizures which were not treated appropriately by the hospital staff intensivists. The defense was supported by the testimony of an expert pediatric neurologist, who testified that the autopsy, and head CT imaging, showed no evidence of brainstem herniation as would have occurred had the death been caused by increased intracranial pressure. He dismissed plaintiffs’ expert pediatric neurosurgeon’s testimony regarding “pressure waves,” and identified seizure activity as a possible cause of the death.
The jury returned a unanimous verdict in favor of the defendant after deliberating for two days.
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