Cervical RFA Suit - $7.36 Million Verdict

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chibadriver

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How did this even happen?

Waterloo, IA - Black Hawk County jury has handed down a multi-million dollar verdict brought by a Waterloo man who lost feeling from the waist down following a medical procedure.

The panel awarded Fredrick Duitsman Jr., 65, a $7.36 million judgment in his suit against Dr. Ashar Afzal and Cedar Valley Medical Specialists on Wednesday following a week of trial.

Jurors found Afzal was negligent in his care for Duitsman, and the verdict included $860,000 for future medical expenses, $200,000 for past lost wages, $200,000 for future lost earning capacity, $3 million for past and future pain and suffering, $3 million for past and future loss of function, and $100,000 for his wife for loss of consortium.

According to the lawsuit, Afzal, who was employed by Cedar Valley Medical Specialists at the time, performed a cervical facet radiofrequency nerve ablation — a pain relief procedure that uses a heated needle to block nerves from sending pain signals — on Duitsman in December 2014.

The procedure caused permanent loss of sensation from the waist down, according to the suit.

The suit was filed in 2016, and Duitsman was represented by attorneys Farl Greene, Tim Semelroth, Pressley Henningsen and Benjamin Long of Cedar Rapids.

Trial began July 16 and jurors started deliberating Monday before reaching a verdict on Wednesday.

wcfcourier.com/news/local/crime-and-courts/multimillion-dollar-verdict-in-waterloo-malpractice-suit/article_8c5177a5-e1f6-5e01-bdd8-537a0a1ac802.html

-Chiba

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I would presume most likely a direct cord injury on someone heavily sedated?
 
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Sucks to be in a state where there’s no cap on pain and suffering. Glad my state has a cap.
 
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Unfortunately, I can't find the court documents online... I mean, something like a nerve root injury maybe, but wow.

Yeah, I think Dr. Duntsch will only have to shell out $250K per patient... although it adds up when you maimed ~30
 
Cervical RFA causing loss of sensation from waist down? The anatomy doesn’t fit.


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Cervical RFA causing loss of sensation from waist down? The anatomy doesn’t fit.


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Sounds like a cervical cordotomy was done instead of a RFA. A neurosurgeon showed me how to do a cervical cordotomy once (for cancer pain). i told him i would never have the nerve (pun unintended) to do it. Cordotomy - Wikipedia
 
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Moral of the story - Keep your needle out of the canal.

That's the only way this can happen...You impale the cord (debate whether that alone would even do this) or impale it and fry it under sedation I guess. I've heard of people sticking needles through the cord completely without any noticeable issue.

This story doesn't scare me. If anything it just reaffirms that my Valium 5mg PO is the right way to lesion.
 
Moral of the story - Keep your needle out of the canal.

That's the only way this can happen...You impale the cord (debate whether that alone would even do this) or impale it and fry it under sedation I guess. I've heard of people sticking needles through the cord completely without any noticeable issue.

This story doesn't scare me. If anything it just reaffirms that my Valium 5mg PO is the right way to lesion.
Co-fellow saw one in training - a CRNA doing interventional pain procedures, had done a cervical RF under propofol - lesioned the cord. Somehow the only deficit the patient developed was severe arm pain. The patient was referred to the academic center for “CRPS”
 
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lol I dont understand why you guys would ever train CRNAs to do any procedures. You guys are training ur replacements!!
 
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That's scary, wonder what happened? Just doesn't seem to make sense this could happen. No motor testing beforehand? No AP and Lateral View to confirm placement? Just bizarre.
 
Imagine his technique was way outside the standard of care during this case
 
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Unfortunately, I can't find the court documents online... I mean, something like a nerve root injury maybe, but wow.

Yeah, I think Dr. Duntsch will only have to shell out $250K per patient... although it adds up when you maimed ~30
Unfortunately, I can't find the court documents online... I mean, something like a nerve root injury maybe, but wow.

Yeah, I think Dr. Duntsch will only have to shell out $250K per patient... although it adds up when you maimed ~30

Nope- you can exceed the limits of your coverage. At that point, your individual assets are at stake.

I used to practice in Iowa. There was this case and another case of "test blocks" causing quadriparesis. In both instances, there was failure to obtain AP views to determine potential contact with the canal. You would be surprised at what goes on in pain clinics around the country.
 
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Similar case in my state. Medical malpractice costs will go up. RFAs may be excluded from policies... we’ve discussed this in past threads.

Tooooo much sedation, bad training, heavy/concentrated local. At least the cases I have reviewed.

I wonder if this provider is ACGME and ABMS certified? May determine his fate. IMO.
 
could be an infection/bleeding that causes hematoma/abscess. anyone has the actual case information
 
Ill bet it was a lateral approach with deep sedation. Was actually aiming at the contra-lateral trapazoid and went into the cord. Happened to one of our fellows in training for a cervical MBB (no sedation).
 
Ill bet it was a lateral approach with deep sedation. Was actually aiming at the contra-lateral trapazoid and went into the cord. Happened to one of our fellows in training for a cervical MBB (no sedation).

You are exactly right. Failure to obtain an AP view as well. The guy used to be on staff at the Univ of Iowa, but it has a very lousy pain program with marginal procedural training.

This guy was no saint, I can tell you that.
 
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