Facts

Plaintiff Kelly Springs presented to defendant Trevor Lynch, M.D. for treatment of lateral epicondylitis (tennis elbow) in December 2000. In September 2001, the defendant performed surgery, which was described as a "modified Bosworth" procedure. This involved detaching the common extensor origin from the epicondyle, debriding diseased tissue from a tendon, then removing a portion of the epicondyle, followed by suturing the common extensor origin back to the bone. In addition, the defendant made an incision halfway down into the annular ligament to loosen it.

After that surgery, the patient developed elbow instability (the elbow dislocated with pressure), which the defendant thought might be as a result of the incision into the annular ligament. In December 2001, he returned the patient to surgery and reconstructed the annular ligament to correct the instability. That surgery failed as well. The defendant then recommended removing the head of the radius to prevent the elbow from dislocating.

The patient then sought an opinion from Neil ElAttrache, M.D. at Kerlan-Jobe. Dr. ElAttrache recommended a ligament reconstruction surgery, which he performed in December 2002. That surgery failed to resolve the problem. In May 2003, Dr. ElAttrache removed the radial head. Subsequently, the patient developed ulnar nerve problems in the elbow which led to two additional surgeries. The claimant is still symptomatic, and may ultimately require additional surgery, the nature of which may depend on future advances in surgical technique.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended that all of the problems she suffered stemmed from the defendant performing too aggressive of an initial surgery. Specifically, the defendant should not have removed so much of the lateral epicondyle (he removed it "flush with the capitellum") and he should not have made the incision into the annular ligament. The plaintiff's contentions were supported by Dr. ElAttrache, her treating physician.

DEFENDANT'S CONTENTIONS:
The operation selected by the defendant was one he has used at least one hundred times over twenty years with no other patient developing elbow instability. The plaintiff's problems stemmed from a broken suture which occurred after the first surgery, an event that the plaintiff's expert admitted was not the fault of the defendant. The defendant attributed the failure to a manufacturing defect in the suture, but destroyed the evidence. The plaintiff was therefore precluded from pursuing a products liability claim.

Settlement Discussions

The plaintiff made a statutory demand of $250,000. The defendant made no offer.

Injuries

Six surgeries, loss of radial head, continued elbow symptoms, need for future surgery.

Other Information

The arbitration took place on Oct. 10-11, 2005. The award was issued on Oct. 28, 2005. The arbitration was held before Hon. Robert Letteau, neutral arbitrator; Ted Hammond, respondent's arbitrator; and Robert Schlifkin, claimant's arbitrator.