Facts

On Aug. 20, 2013, plaintiff, Richard underwent a posterolateral spinal fusion surgery including posterior hardware and posterolateral mass screw implantation at the C5, C6 and C7 levels and posterior pedicle screw implantation at the T2, T3 and T4 levels. The surgery at Hoag was a co-surgeon operation performed by spine surgeons, Todd W. Peters, M.D., and Burak Ozgur, M.D. The surgery was noted to be a difficult case, requiring twice the usual operating time and the need for significant operative devices, including a microscope, stereotactic navigation and operative neurologic monitoring.

Following the surgery, plaintiff remained at Hoag for post-operative care and pain management. While hospitalized, he received pain medication for his stated pain levels, which consistently ranged from 8-9/10. The pain management team consisted of physicians and physician assistant Mark Schwartz. On or around Aug. 25, plaintiff's oxygen saturation levels were noted on the lower side and on Aug. 26, his oxygenation decreased into the 70's. The Rapid Response Team was called to consult, and three separate doses of Narcan were administered over a period of approximately five hours. Shortly thereafter, his oxygen saturation levels normalized and he became more alert and arousable throughout the remainder of his stay at the Sub-ICU until he was ultimately discharged on Aug. 28.

PLAINTIFF'S CONTENTIONS: Plaintiff contended that the management of his post-operative pain during the course of his hospitalization at Hoag was inappropriate. Specifically, he contended that he was kept overly sedated on narcotics, which purportedly resulted in manual chest compressions to resuscitate him on Aug. 26, 2013 and/or that as a result of using an Ambu bag for oxygen administration by the Rapid Response Team. The Ambu bag administration included an alleged violent chin/head tilt. The surgically implanted spinal hardware became loose requiring subsequent repair surgery months later.

Plaintiff further contended that the Narcan caused his violent shakes and seizures, which further caused or contributed to the loosening of the spinal hardware and loss of fixation.

DEFENDANT'S CONTENTIONS: Defendant Hoag contended that at all times its nursing and ancillary personnel complied with the standard of care in the treatment and care of plaintiff during his August 2013 hospitalization. Specifically, the nursing staff complied with the standard of care as they properly administered the prescribed doses of medication to plaintiff at all times. Defendant Hoag also contended it properly monitored plaintiff's reaction to the medications that were prescribed and administered during his admission from Aug. 20, 2013 through the Rapid Response Team Intervention on Aug. 26, 2013 and until the time he was discharged from Hoag on Aug. 28, 2013.

Defendant Hoag further contended that no action or inaction on the part of its staff caused or contributed to the displacement of the instrumentation screws implanted in plaintiff's spine during his posterolateral spinal fusion surgery on Aug. 20, 2013. It was Hoag's position that that the displacement of the instrumentation screws was the result of a less than optimal screw fixation at the C5, C6 and C7 levels during plaintiff's Aug. 20, 2013 spinal fusion surgery. In addition, the rods implanted were too stiff in comparison with the anchoring ability of the bone, which placed additional pressure on the instrumentation screws at the C5, C6 and C7 levels and contributed to the posterior displacement of the instrumentation screws.

Defendant Schwartz contended that at all times he complied with the standard of care for pain management and the administration and adjustments of the medication and narcotics being administered to the plaintiff during the hospitalization at Hoag. He contended his work was reviewed by supervising physicians as part of a pain management team overseeing the patient's pain management.

Defendant Schwartz further contended that the administration of the medication did not result in a code blue situation, wherein cardiopulmonary resuscitation was administered including the use of manual chest compressions to revive the patient. If a chin tilt was used to assist in administration of oxygen by an Ambu bag, such movement had nothing to do with the loss of fixation of the patient's spinal hardware.

Additionally, defendant Schwartz contended that the taking of Narcan did not result in any side effect that would create force necessary to dislodge the spinal hardware and such did not occur.

Damages

The jury was asked to return an award of between $564,000 to $798,043 in special damages for cost of repair surgery and future medical care, as well as an additional $250,000 in non-economic damages.

Injuries

Frame, 53, underwent a posterolateral spinal fusion surgery at the C5-6, C6-7, C7-T1, T1-T2, T2-T3, T3-T4 and T4-T5 with a decompressive laminectomy at T1, decompressive laminectomy 50 percent at T2, and decompressive laminectomy 50 percent at C7. Plaintiff claimed that as a result of defendants' alleged negligence, he was required to undergo an additional surgery to repair the surgery for placement of the spinal instrumentation and he also claimed he suffered emotional distress.

Result

Defense verdict in favor of both defendants, Hoag Memorial Hospital Presbyterian and Schwartz.

Deliberation

two hours and 50 minutes

Poll

10-2 (in favor of Hoag), 11-1 (in favor of Mark Schwartz)

Length

10 days