Facts

Plaintiff Harriet Hadelman filed suit against defendant Lee W. Erlendson, M.D., claiming that a 1.5-inch local anesthetic needle that pierced plaintiff's cervical spinal cord during the administration of local anesthetic prior to a left C4-5 cervical facet steroid injection.

PLAINTIFF'S CONTENTIONS:
Plaintiff claimed that the 1.5-inch needle directly penetrated the cervical spinal cord causing abnormal signals on MRI, a lesion of the cervical spine at C3-4. Plaintiff alleged that the direct needle trauma caused permanent neuropathic pain in plaintiff's left neck and upper extremity and resulted in physical limitations and disabilities.

DEFENDANT'S CONTENTIONS:
Defendant argued that it was physically impossible, to a reasonable degree of medical probability, for the 1.5-inch local anesthetic needle to have reached the cervical spinal cord at levels C3-4 and/or C4-5. Defense demonstrated through animations including the depiction of cross-sectional axial MRI images that the needle simply could not reach the cord. Every measurement depicted, from skin surface to cord, on the animation and testified to by the experts was greater than 1.5 inches. In addition, the evidence demonstrated that the needle was not even fully into plaintiff's skin when during the local anesthetic administration, plaintiff complained of pain and paresthesia down her left arm and leg.

Although not the defense's burden, an animation was presented that depicted the vascular anatomy of the cervical spine and defense experts presented a theory to the panel that the lesion in the cord was caused by the needle striking a nearby artery, a branch of the ascending cervical artery in the posterior aspect of the cervical musculature at C4-5. This caused it to go into vasospasm resulting in the formation of a blood clot that embolized to the cord causing a posterior spinal cord infarction and subsequent tissue death, e.g. a spinal cord stroke or infarction similar to a cerebral stroke. This infarction resulted in the cord lesion seen on plaintiff's MRIs of the cervical spine.

Result

Defense arbitration award.

Other Information

ARBITRATORS: Joseph Thielen (neutral arbitrator), Sean Burke (plaintiff's arbitrator), Robert McKenna (defense arbitration). FILING DATE: Nov. 20, 2014.