INFORMATION FOR NEW LNCs

IT'S ALL FREE!

LNCtips.com: 2 Sides to the Story


I recently watched Making a Murderer, a fascinating Netflix documentary series told from the Defense viewpoint about a man convicted of killing a woman. (See the trailer here.)  As the story unfolded, I, like many viewers, wondered if an injustice had occurred.  Then I listened to Rebutting a Murderer on iHeartRadio, which looked at the evidence from the prosecutor's viewpoint.  After listening to the rebuttal, I had a better understanding about why the man was convicted.  These two events reminded me that in medical malpractice cases, both plaintiffs and defendants can look at the same set of facts and propose two very different and plausible theories. Here's an example of a real medical malpractice case with two sides to the story.

The plaintiff, Arden Trevino, was a wealthy and prominent businessman with a history of low back pain.  He was in the process of receiving a workup for the low back pain and had recently had an MRI of his lower back.  Eight days after the MRI, Mr. Trevino bent over to pick up the Sunday morning newspaper and he had a severe back spasm.  He related that it felt like "something snapped" in his lower back.  Mr. Trevino went to a Medical Memorial Hospital, where he was seen by his personal friend, Dr. Huey Johansen, an orthopedic surgeon.

Dr. Johansen ordered a cervical MRI, which was never performed for unclear reasons.  He also reviewed the results of the recent lumbar MRI, which revealed the presence of severe lumbar stenosis at L3-L4 and L4-5.  Although Mr. Trevino wanted surgery, Dr. Johansen suggested epidural steroid injection prior to any surgical interventions.  Dr. Garth Hamrick, a pain management anesthesiologist performed an intralaminar epidural steroid injection at L3-L4 under fluoroscopy a few hours later.

Several hours after the epidural steroid injection, Mr. Trevino discovered that he had scrotal numbness and was unable to urinate.  Mr. Trevino called another personal friend of his, Dr. Eddy Cline, a neurologist.  Dr. Cline was not on call but immediately came to the hospital, examined Mr. Trevino, and ordered a STAT spinal MRI.  Along with Dr. Johansen, Dr. Cline attempted multiple times to get the MRI performed but Mr. Trevino was unable to tolerate the procedure.  In lieu of the MRI, Dr. Cline ordered CT scans of the cervical and lumbar spines, which revealed the presence of multi-level degenerative changes at C5-C6, C6-7, and L2-5. 

Early the next morning, Dr. Johansen performed surgical decompression of Mr. Trevino's spine.  Following the surgery, Mr. Trevino experienced numbness in his left foot.  A STAT MRI ordered by Dr. Johansen showed a large posterior disc extrusion at L3-L4 causing mass effect on the cauda equina.  Mr. Trevino was taken back to surgery where Dr. Johansen performed an L3-L4 discectomy.  However, Mr. Trevino was left with a permanent left foot drop and numbness in the scrotal and buttocks areas.

Mr. Trevino sued Medical Memorial Hospital and Drs. Johansen, Hamrick, and Cline.  The plaintiff's theory about the case included:

* Medical Memorial Hospital was vicariously liable for the actions of Dr. Johansen, Hamrick, and Cline.

* Dr. Johansen failed to monitor the patient intraoperatively and postoperatively, delayed performing a lumbar decompression, and negligently performed it when he finally operated.

* Dr. Hamrick negligently gave Mr. Trevino no indication of the true risks of epidural steroid injections, and negligently performed an epidural steroid injection even though Mr. Trevino had spinal stenosis.

* Dr. Cline negligently failed to consult an anesthesiologist to perform MAC anesthesia to ensure that an MRI could have been performed.

The defense theories in the case were the following:

* Dr. Johansen's theory was that both surgeries were performed timely and appropriately.  His expert opined that the extruded disc which caused the foot drop was the result of the initial decompressive surgery.  The surgery successfully alleviated the decompression to the extent that the disc at L3-4 was capable of movement.  The disc then extruded or herniated, an unfortunate complication that could not have been foreseen or prevented.

* Dr. Hamrick's theory was that epidural spinal injections are common procedures for spinal stenosis.  He also produced a consent form with a detailed list of possible risks, which had been signed by Mr. Trevino.

* Dr. Cline's theory was that there was nothing else that could have been done or that needed to be done to insure than MRI was conducted, and that the previous MRI and the cervical and lumbar CTs provided sufficient information about the patient's condition.

* Medical Memorial Hospital agreed with the theories put forth by the other defendants.

What was the end result?  Dr. Johansen and the hospital quickly agreed to confidential settlements.  The case went to trial against Drs. Hamrick and Cline, and both defendants received verdicts in their favor.  Needless to say, Drs. Johansen and Cline are no longer personal friends with Mr. Trevino.

...Katy Jones