Spinal Nerve Damaged in Carotid Procedure

This case concerns the carotid endarterectomy of an elderly man’s artery, which left him with numerous medical complications. The surgery was assessed to be without any adverse side-effects at the time; however, days after the operation the patient began to complain of a constant sharp pain in the left side of both his shoulder and his neck. An electromyography was conducted to test the patient’s muscle response, and revealed severe damage to the spinal accessory nerve. Despite the successful surgical repair of his artery, the patient was left with limited use of his left arm.

Question(s) For Expert Witness

1. Do you routinely perform this procedure?

2. Have you ever encountered this complication?

Expert Witness Response E-019380

I perform multiple carotid endarterectomies on a regular basis, and I am very familiar with the complications of this surgery. I have never seen or even heard of this complication since this particular nerve is not usually in that anatomical region - it sounds like it is possible the dissection was conducted in the wrong area, or that there was an anatomical variation.