Misplaced External Fixator Nerve Palsy Lawsuit

Wilson v. University of Maryland Orthopaedic Associates

ArmThis medical malpractice claim was filed in Baltimore City after a woman suffered nerve palsy in her left hand due to improperly placed external fixator pins. It was filed in Health Claims Arbitration on March 13, 2018, and it is the 126th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A woman went to the University of Maryland Medical Center (UMMC) after suffering a left elbow fracture and dislocation. Physicians applied an external fixator to stabilize the surgical site and then repaired the woman's ligament and dislocated elbow. The woman was noted to have a left wrist drop after the procedure, but she was discharged anyway.

When the woman returned to her physician one month later, she was diagnosed with left radial nerve palsy. In other words, the fingers on her left hand could not extend at the joint closest to her palm. Three months later, the woman underwent a nerve graph and tendon transfer surgery in the hopes of correcting her nerve palsy. During the procedure, her physician noticed a significant amount of scarring in the radial nerve, at the same location where one of the pins from her external fixator had been placed.

The woman had multiple follow-up procedures to attempt nerve repair. None of the procedures were successful and she continues to suffer from weakness and pain in her left arm.

Additional Comments
  • A wrist drop is when there is paralysis of muscles in the arm that lift the hand at the wrist. Most wrist drop cases, like this one, are the result of nerve damage.

  • According to the claimant's expert witness, an orthopedic surgeon, the external fixator pins were supposed to go in the proximal humerus so as to avoid injury to the radial nerve. The claimant's doctors did not properly visualize her humerus before placing the fixator pins, and as a result, they accidentally drilled into her radial nerve. The whole injury could have been avoided if the doctors had used the correct radiographic technique.

  • You sometimes see these injuries when the surgeon clamps the brachial artery or the median and radial nerves. So you can imagine if the surgeon drills into the radial nerve.

  • There are not a lot of wrist drop medical malpractice cases so on some level this is a rare case. But the core of this case is the failure to visualize the surgical field which common theme in surgical malpractice cases. The underlying premise of these claims is that a surgeon should not cut if she does not know where she is cutting.

  • Back in 2015, there was a defense verdict in Montgomery County in a wrist drip case. Plaintiff's expert plaintiff's testified that the surgeon at Montgomery Orthopaedics breached the standard of care by failing to order an EMG and a neurosurgery consultation shortly after surgery for an injured elbow. The doctor's lawyers fought that case on both negligence and causation. The causation argument was that even if the doctor was negligent there was no solid evidence the doctor's mistake caused the plaintiff's nerve damage. There apparently was some evidence a jury could rely upon to conclude that the nerve damage was chronic. This does not appear to be a likely viable defense in this case.

Jurisdiction
  • Baltimore City
Defendants
  • University of Maryland Orthopaedic Associates, P.A.
Hospitals Where Patient was Treated Negligence
  • Failing to use proper technique to place the external fixator pins.
  • Failing to visualize the humerus before drilling the external fixator pins.
  • Failing to remove the external fixator in a timely manner so as to avoid further injury.
Specific Counts Pled
  • As a direct result of the defendant's negligence, the claimant suffered painful and permanent injuries that diminish her quality of life and require expensive medical treatments.
Plaintiff's Experts and Areas of Specialty
  • Kenneth R. Lippman, M.D., F.A.C.S, Orthopedic Surgeon
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