Surgical team lacerates patient’s sciatic nerve

In 2005, the patient, 64, experienced increasing pain and stiffness in his right hip. He was evaluated by an orthopedic surgeon who determined that he was a candidate for total hip arthroplasty.
On Sept. 13, the patient underwent a total right hip replacement at a VA hospital. When the patient awoke from surgery, he was numb from his hip to his foot and began to experience severe pain.

The operative report indicated that the patient’s sciatic nerve had been lacerated.

According to the report, the laceration was “probably caused by the electrocautery coming too close to the nerve.”

An EMG and nerve conduction study revealed that the patient suffered sciatic nerve damage with severe right-sided sciatic neuropathy and severe axonal loss. The patient experienced decreased sensation and motor function with foot drop and was given a multipodus boot and custom solid ankle AFO.

As a result of the surgery, the patient sometimes requires a cane to walk and has a compression dressing on his right foot up to his knee. He experiences persistent numbness and burning pain from his right knee to his toes.

The patient alleged that the VA hospital and its employees deviated from the applicable standard of care when they caused discrete and definite damage to his sciatic nerve as a result of the use of an electrocautery tool.

The patient also alleged that they failed to take necessary measures to identify and protect the sciatic nerve from this type of injury, such as palpating and/or visualizing the sciatic nerve during surgery, using appropriate retraction or a lap pad and/or using the short external rotator hip muscles.

The case settled for $450,000.

Type of action: Medical malpractice
Injuries alleged: Sciatic nerve injury, foot drop
Date: Jan. 26, 2009
Submitted by: Jeffrey N. Catalano, Todd & Weld, Boston (for the patient)