Case details
Defense: Repositioning of patient before surgery not uncommon
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
emotional distress, mental, neurological, psychological, radiculopathy
FACTS
In April 2013, plaintiff Patricia Speakman, an administrative assistant in her 40s who worked for the U.S. Bank National Association, underwent a surgery for stress urinary incontinence. A suburethral sling was placed during the surgery, which was performed by Dr. Bruce Kahn, a urogynecologist. Speakman claimed that she sustained a lumbosacral plexus injury and nerve irritation due to Kahn negligently positioning her in the lithotomy position intraoperatively. Speakman sued Kahn and Kahn’s medical office, Scripps Clinic Medical Group Inc. Speakman alleged that Kahn negligently treated her and that Kahn’s actions constituted medical malpractice. She also alleged that Scripps Clinic was liable for Kahn’s actions. Plaintiff’s counsel focused on one post-operative progress note in particular, in which Kahn documented that Speakman was positioned with “extreme flexion of the hips” prior to surgery. Counsel contended that this was recognized prior to the start of the 20-minute procedure and that Speakman’s hips were repositioned to extend the legs to 90 degree angles. According to plaintiff’s counsel, it was below the standard of care to position Speakman’s legs with extreme flexion of the hip. Specifically, counsel introduced evidence that Speakman’s , which alleged do not occur in the absence of negligence, could only have resulted if Speakman’s hips were both hyperflexed and hyper-abducted intraoperatively. Defense counsel contended that there was no evidence that Speakman’s leg was hyperflexed and hyper-abducted intraoperatively. Counsel argued that Kahn made every possible effort to determine the cause of, and treat, Speakman’s post-operative symptoms and that while he was considering all potential causes, Kahn documented in his medical records that Speakman’s leg was observed to be hyperflexed and repositioned it prior to the start of the surgery. Counsel noted that they calculated the maximum amount of time that the hips were with extreme flexion and that it was, at most, 19 minutes. Thus, defense counsel argued that it was not below the standard of care, or even uncommon, for a urogynecologist to fine tune a patient’s lithotomy positioning prior to beginning a procedure. Counsel further argued that even if Speakman did experience a lumbosacral radiculopathy or plexopathy, those would have nothing do with lithotomy positioning. The defense’s board-certified urology expert, who also specializes in urogynecology, opined that it was not below the standard of care for Kahn to note that the hips were hyperflexed and to reposition them. The expert also opined that it was common to reposition before or during surgery and that Kahn went above and beyond in his care., Speakman claimed that when she woke up post-operatively, she noticed the widespread radiculopathy in her left leg. She claimed that despite her diligent efforts to rehabilitate her left leg and attend physical therapy, she did not feel that it helped. She also claimed that she tried to rehabilitate her leg on her own, but that she still experiences instability and weakness, such that she is unable to squat down without a bar to assist her or sit for long periods of time. Speakman claimed that she went on disability after the surgery. She also claimed that she suffers from emotional distress as a result of her injury, but that she did not undergo counseling. However, Speakman claimed that she will have minor medical costs for her future neurology appointments. Thus, Speakman sought recovery of $10,000 in past and future medical costs, $25,129.27 in past lost income, $1,500 in possible annual bonus loss, $1,000 for her employer-provided 401(k) and loss of 252 unaccrued vacation days, and $384 for medical leave. Defense counsel contended that Speakman’s symptoms were initially musculoskeletal in nature and that the symptoms Speakman claimed she still had in 2016 were not the same symptoms she complained of after her surgery in 2013. The defense’s neurology expert testified that, based on Speakman’s symptoms, he did not believe that Speakman’s condition was lumbosacral radiculopathy or plexopathy. Defense counsel noted that Speakman reluctantly admitted on cross-examination that she began taking flying lessons seven months after her surgery, while she was also receiving partial disability benefits. Defense counsel also disputed Speakman’s testimony about her continued complaints of left leg instability and introduced various Facebook pictures, which depicted Speakman balancing on her left leg on the strut of an aircraft and squatting beneath the aircraft to check the fuel. Counsel further argued that the pictures demonstrated that Speakman’s symptoms were not as severe as she claimed.
COURT
Superior Court of San Diego County, San Diego, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
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- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
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