Brain Injury Law Blog : Head Injury : Coma : Las Vegas Nevada Lawyer Tim Titolo

An article in this week's Surgery Special Issue of The Lancet reports that surgery for carpal tunnel syndrome in patients (without an indication of severe nerve damage known as denervation) provides better outcomes than non-surgical treatment. However, the clinical relevance of this difference is modest. The article is the work of Professor Jeffrey Jarvik, of the Harborview Medical Center, University of Washington, Seattle, USA, and colleagues. 
Read more here. 

 "Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial"
Jeffrey G Jarvik, Bryan A Comstock, Michel Kliot, Judith A Turner, Leighton Chan, Patrick J Heagerty, William Hollingworth, Carolyn L Kerrigan,Richard A Deyo
Lancet 2009; 374: 1074-81
The Lancet
 

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The negligent performance of lumbar surgery may also give rise to litigation. Negligence in the actual performance of lumbar surgery, however, is infrequently documented in the medical
records and may be difficult to prove. On the other hand, such actions as performing a diskectomy or laminectomy at the incorrect level almost always falls below the applicable standard of care and can be independently proven.

Other examples of negligence during surgery include certain aspects of lumbar fusion surgery, iliac vein or aortic perforation, and the failure to repair a dural tear or leak when recognized.

Examples of intraoperative mishaps that rarely rise to the level of medical negligence include dural tears, cerebrospinal fluid leaks, excessive bleeding and inadvertent nerve root injury.
Overall, mishaps during the technical performance of lumbar surgery constitute the fewest instances of medical negligence.Finally, the failure to diagnose and treat a postoperative
complication may give rise to medical care that breaches the applicable standard of care.

Many post-operative complications following lumbar surgery involve either infection or neurological dysfunction. Infection following lumbar surgery, in and of itself, is usually not medical
negligence; the failure to diagnose and treat such an infection, however, may constitute medical negligence. The failure to diagnose and treat a post-operative disk space infection can
also constitute medical negligence. The presence of a postoperative neurological deficit, in and of itself, may not constitute medical negligence, but the failure to evaluate and treat such a
deficit may be medical negligence.

The failure to provide adequate post-operative follow-up care may constitute medical negligence. In general, close followup of a patient following lumbar surgery is indicated, and the threshold for performing post-operative imaging including MRI scanning must be low for evaluating neurological dysfunction or infectious processes.

In summary, back pain and lumbar surgery are common medical entities and may be associated with medical negligence giving rise to litigation.

The actual performance of the surgical procedure may give rise to negligence but only in specific instances that may be independently proven.

More commonly, litigation arises from a failure to diagnose the disease entity prior to surgery or a failure to evaluate properly, diagnose and timely treat the patient in the post-operative
period. For these very reasons, an experienced expert witness is necessary to evaluate cases involving lumbar disease and surgical procedures.

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Rhode Island Hospital has been fined $50,000 and reprimanded by the state Department of Health after its third instance this year of a doctor performing brain surgery in the wrong side of a patient's head.

I've heard of doctor's who amputate the wrong leg while the patient is on the operating table.  This lead to patients writing "this leg" on their leg before going in for surgery.  How, I wonder, can we help the busy, busy medical community to not drill holes in the healthy part of our brains?

Check it out.

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W. L. Gore & Associates announced today the availability of GORE PRECLUDE® Vessel Guard, the first non-biological membrane indicated as a cover for vessels following anterior vertebral surgery.

This device will make anterior approach surgical procedures safer.  The advanced biomaterial reduces the risk of potential vascular injury by providing a permanent and visible plane of dissection around the vasculature to facilitate anterior revision surgery.

It is well known that anterior approaches to the spine are associated with some risk of vascular injury, particularly among patients having undergone previous anterior spinal surgery.  It is expected that the new membrane will provide a vascular tissue-friendly interface giving surgeons, and their patients, greater confidence and peace of mind during anterior revision procedures.

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