SUMMARY: The patient's side of the Malpractice Story. A Multidisciplinary Discussion to learn the challenges faced by a patient in reaching a Medical Malpractice Settlement including neurosurgeons, the patient, and a lawyer. The case is reviewed with the patient and her husband, explaining her preoperative state, surgical experience, and post operative course, recovering from complications at surgery. Pre-operatively she had numbness and pain of C7 and a motor and sensory deficit, that was not responsive to medical treatment. Surgery was chosen with an ACDF. Post-operatively she was quadriparetic with a predominant Brown- Sequard syndrome. An MR was performed immediately post-op and showed cord swelling and white matter densities in the spinal cord at the surgical site. The patient and her husband were not told of the MR changes and nothing was done further. No other consultation was obtained. She went to Rehab. She describes difficulties obtaining the facts of what happened. Several lawyers could not obtain the facts, or mentioned that, 'It was the standard of care'. The final lawyer pursued the case, which revealed multiple errors, from not recording the penetration of the cord at surgery with a spacer, to finally admitting the error. It was believed that nothing could be done to help this patient, immediately post op.
There was extensive cover-up of the facts at many levels. Why? Mistakes are and will be made at surgery. What is the Truth? Are the Healthcare system incentives built to hide these errors? Is the education system adequate? How can these situations be avoided or improved? Other basic principles involved in malpractice cases are discussed. Not fixing the system is unacceptable. What should be done that places the 'patient first' to fix the Medical Malpractice problems? How can we make these situations better? Solutions are offered. 75 min; (JIA)