During the litigation, further examination of the foreign object showed that it bore no resemblance to a spinal needle and matched nothing used in the needle drawer at the hospital where Dr A administered the anesthesia.
During the workup of the case, Dr A's defense counsel questioned the plaintiff about whether he had received medical treatment during a trip that he had made to India 3 years prior. The plaintiff denied receiving surgical care in India during that time.
Defense counsel then obtained from India samples of cannulas used by physicians in that country. The samples matched the object removed from the patient. Despite the finding, the plaintiff's counsel refused to dismiss the case but instead presented an expert who theorized that Dr A used some blunt needle as an introducer which broke and that the fragment was pushed by a spinal needle through to the ligamentum flavum.
At trial, Dr A's defense attorney proposed that the plaintiff traveled to India after suffering from stenosis and underwent either minimally invasive spine surgery or an epidural injection, and it was then that the foreign object was introduced and retained. In trial, the plaintiff testified that he had no procedures performed after hurting his back while landscaping his yard 3 years earlier because his back got better by itself.
When Dr A testified at trial, her defense attorney asked her if she could think of a theory other than that put forward by the plaintiff's expert. Dr A responded that she had done some research into the matter and learned that physicians in some Commonwealth countries, like the former British colony of India, use cannulas in their suction procedures.
After 12 days of trial, the jury deliberated for 1 day before finding in favor of Dr A by a vote of nine to three.
This case underscores that not all malpractice claims are what they seem from the start. It helps to have a knowledgeable attorney and legal team who do their homework prior to trial. In this case, an investigation into where the patient had traveled and a little research about the location helped get to the bottom of the allegation — and exonerated the doctor before it was too late.
This case comes from the “Case of the Month” column featured in the member newsletter published by the Cooperative of American Physicians, Inc. The article was originally titled "Jury Solves Mystery of Retained Foreign Object."
© 2021 Cooperative of American Physicians, Inc.
This case comes from Medicine on Trial, originally published by Cooperative of American Physicians, Inc., to provide risk management lessons from litigated case histories.