Radical Prostatectomy Results in Severe Nerve Damage and Paralysis

This case involves a fifty-five-year-old male patient who underwent a holmium laser enucleation and total prostatectomy procedure and suffered many adverse complications. The patient complained of postoperative leg weakness, with the limited ability to ambulate. After the procedure, the patient continued to suffer from neurapraxia and rhabdomyolysis acutely that contributed to long-term leg weakness issues. The possibility of a nicked nerve during the radical resection procedure was not ruled out. Additionally, the patient underwent further independent medical examinations to uncover a source of the leg weakness.

Question(s) For Expert Witness

1. Is it possible that this injury was linked to the surgical procedure?

Expert Witness Response E-000336

Even the careful and knowledgeable spine surgeon will encounter a variety of neurologic complications during and after routine lumbar laminectomy. These include dural and nerve root injuries, cauda equina syndrome, and formation of scar tissue, extradural and intradural (arachnoiditis). The surgeon must be prepared to identify each of these problems and deal with them effectively at the time of the procedure, postoperatively, and during follow-up periods. The physician evaluating a patient with multiple spinal operations must use an organized approach. The origin of the problem in most instances is a faulty decision to perform the original operative procedure. Further surgery on an "exploratory" basis is not warranted in any situation and most likely will only lead to further disability. Feedback provided by a medical malpractice expert witness.