A recent lawsuit against the Medical University of South Carolina (MUSC) has highlighted critical concerns in surgical safety protocols after a pediatric spine surgery led to permanent paralysis in a 12-year-old girl with cerebral palsy. The case highlights the importance of precision in spinal screw placement and thorough postoperative monitoring, especially in vulnerable patient populations.
Incident Overview:
The lawsuit, filed on September 4, 2024, centers around a May 2021 scoliosis surgery during which the pediatric orthopaedic surgeon allegedly misplaced three screws in the patient’s spine. Despite initial assurances from the surgeon that the screw placement was acceptable, the patient experienced increasing paralysis in the days following the surgery, eventually losing movement in her hips, knees, ankles, and feet.
A CT scan taken nine days after the surgery revealed that the screws had likely intruded into the spinal canal. Although a corrective surgery was performed to remove the screws, the damage had already been done. The girl remains paraplegic, unable to regain movement in her lower extremities.
Legal and Medical Implications:
The lawsuit accuses the surgeon and MUSC of negligence and recklessness. According to an expert witness affidavit by Dr. Harry Shufflebarger, a noted pediatric spine surgeon, the defendants failed to meet the standard of care by not identifying the misplaced screws earlier. Additionally, the failure to order timely diagnostic imaging and inadequate monitoring of the patient post-surgery contributed to the irreversible outcome.
Dr. Shufflebarger noted that had proper imaging been ordered sooner, the misplaced screws could have been addressed before causing severe damage. His affidavit reflects the significance of timely interventions and the need for surgical teams to remain vigilant in postoperative care, particularly when patients present neurological deficits after complex procedures.
Key Takeaways for Orthopaedic Surgeons:
For orthopaedic surgeons, especially those involved in pediatric and spine surgeries, this case highlights the necessity of precision in screw placement and comprehensive postoperative monitoring. Some critical takeaways include:
- Intraoperative Imaging: The importance of utilizing advanced intraoperative imaging tools, such as O-arm navigation or 3D CT, to ensure accurate placement of pedicle screws cannot be overstated. These tools provide real-time feedback and help surgeons avoid potential complications.
- Postoperative Neurological Monitoring: Continuous neurological assessment following spine surgeries is critical. Any signs of deterioration should prompt immediate imaging and investigation to rule out mechanical causes such as misplaced screws or hardware complications.
- Timely Intervention: In cases where hardware complications are suspected, time is of the essence. Early detection and corrective action may prevent irreversible neurological damage.
Moving Forward: Ensuring Best Practices:
This tragic case serves as a stark reminder of the risks associated with spine surgeries, particularly in pediatric patients with pre-existing neurological conditions like cerebral palsy. Orthopaedic surgeons must prioritize precision, postoperative vigilance, and rapid response to complications to prevent such outcomes.
As the lawsuit unfolds, the orthopaedic community will likely look to the outcome for lessons in refining surgical protocols, risk management, and patient safety practices in spine surgery.
This case not only serves as a call to action for surgeons but also for healthcare institutions to ensure that safety protocols are strictly adhered to, minimizing the risk of catastrophic outcomes for patients.
Learn more about the ongoing lawsuit at Live 5 News or the Miami Herald.
