We received a call from a 50 year old female patient who went into the
hospital for a hysterectomy.
When she awoke from the surgery, she had a severely disabled leg.
She had very limited control in her leg. Apparently, the surgery that
was anticipated to last 2 hours, lasted almost 8 hours. The allegation
was that there was a positioning error. The positioning error could have
been that she was improperly positioned, improperly padded, or not properly
re-positioned throughout the surgery. Obviously one of the problems in
positioning cases, is that the patient is unconscious throughout the surgery.
The question that was posed during the evaluation of the potential case
had to do with responsibility. In consulting with an OB-GYN/surgeon, an
anesthesiologist and a legal nurse consultant, we quickly appreciated
that positioning cases are very difficult to clearly establish responsibility.
The anesthesiologist’s opinion is often that it is the nurses’
responsibility to properly position and pad the patient, and it is the
surgeon, or in this case, the OB-GYN/surgeon who is the “captain
of the ship”. It is the surgeon’s opinion most often that
he or she is focused on the surgery and positioning is the responsibility
of the nurses. Additionally, surgical opinions may include that the anesthesiologist
is in the surgery to protect the patient and observe and suggest the need
for repositioning. Finally, the legal nurse consultant’s opinion
was that, although, padding and positioning is a responsibility of the
hospital staff, such padding and positioning is under the instruction
of the physician in the surgery suite and re-positioning is only done
if so ordered by one of the other doctors. In that we had the inability
to point the finger to a specific doctor, nurse or other medical professional,
we chose to not take the case and encouraged this patient to consult with
another attorney that practices medical malpractice cases in an effort
to secure help.