Spinal Stimulator Implantation Causes Incontinence

This case involves a 51-year-old male who had a complicated surgical implantation of an electronic stimulator for the management of chronic pain in the right arm that was localized to the bicep, forearm, and fingers. The patient underwent several rounds of injection therapy but failed to receive any benefit at which point the surgeon recommended the stimulator device. The surgery was met with many complications including a severely hypotensive episode with bradycardia which prompted the surgeon to abort mid-way through the procedure. The patient awoke in excruciating pain and continues to have chronic pain worse than that before the procedures were attempted. The patient additionally had bowel and bladder incontinence and experiences muscle spasms which radiate from his feet to the upper extremities and abdominal cavity. Imaging reports state that the patient sustained injuries to C4-C5 with focal spinal cord injury due to the implantation procedure.

Question(s) For Expert Witness

1. What is the standard of care for a surgery like this?

2. What caused the spinal cord injury or infarct?

Expert Witness Response E-000116

These types of procedures are very difficult to assess because pain is a very subjective issue that varies widely from one patient to another. But the bowel and bladder incontinence is very concerning to me and this may be considered to be negligent if the patient had no problems with urination or defecation prior to the procedure. It is difficult to say exactly what caused the nerve damage but the surgical technique of the surgeon may be questioned since the implantation of such devices are relatively non-traumatic.