There is no question surgery can be dangerous. Doctors often have to do a lot of complex things. To use a sports analogy, surgeons often have to make a lot of difficult diving catches for a surgery to be successful.
Continuing the sports analogy, getting the surgical position right generally not a diving catch but an easy pop fly surgery. Prior to operating, surgeons, nurses, and anesthesiologists need to ensure that a patient is positioned properly. If the doctors fail to meet the responsibility, the result can be pain, lifelong injury, and even death. Common injuries include pressure sores, brachial plexus injuries, spinal cord, damage to key organs from lack of oxygen and lumbosacral nerve root injuries. These claims usually are brought against the anesthesiologist. The surgeon may or may not be named as a defendant, depending on the facts of the case.
Surgical Positioning
Surgical positioning is just that, being positioned properly before surgery. Based upon the procedure, the operating room staff has to place the patient in the proper configuration to give access to the surgical site. For example, most patients are placed in a supine position, which entails simply laying on your back. This is the proper configuration for abdominal surgeries. Shoulder surgeries may require patients to be placed in a “beach chair” position, which gives surgeons access to the patient’s shoulders and supports their legs as if seated in a beach chair. Regardless of the position used, operating room staff needs to ensure the following when selecting a position:
- Every member of the surgery team can see the surgical site.
- The surgeon has the best access to the site.
- The anesthesiologist has proper access to administer anesthesia.
- The position minimizes the risk of nerve damage, bleeding, pain, and respiratory/circulatory issues.
Notwithstanding the “easy fly ball” metaphor, proper positioning is not “one size fits all.” Depending on the height, weight, health, and condition of the patient, a surgeon might have to make a judgment call on how to position the patient. Plus, if a patient has circulatory conditions or diabetes, they may require the use of certain tools or padding to avoid further complications.
Why Proper Surgical Positioning is So Important
Patients coming out of surgery can feel pain in areas that were not associated with the surgery site. This usually stems from stretched nerves or muscles that result from improper surgical positioning. While pain caused by improper positioning may be temporary, prolonged stress can actually result in trauma to nerves and muscles. There have also been instances of hypertension and circulation issues due to positioning. When a surgeon places a patient in a position that requires one part of their body to be higher than another, blood pressure readings can be inconsistent across the body, leading to these complications.
Because a patient’s physical and medical characteristics come into play when determining the most appropriate surgical position, doctors often have to make judgment calls. When this happens, it is up to them to make sure that the patient is in the safest position possible with the smallest chance of injury. Malpractice lawsuits often follow when doctors substitute “easiest” for “safest.”
The key to these questions is whether the healthcare provider breached the standard of care. What does that mean? The standard of care represents the expected level of skill, care, and diligence that competent medical professionals would provide under similar circumstances.
For surgical positioning, this standard involves a thorough evaluation of the patient’s specific risks, such as preexisting medical conditions, obesity, circulatory issues, or nerve sensitivity. Proper positioning requires using supports, straps, or padding to protect sensitive areas, prevent pressure on nerves, and reduce the likelihood of muscle or nerve damage. When medical teams fail to assess these needs or overlook proper precautions, they breach the standard of care.
This breach is especially relevant—and frustrating— in positioning injury lawsuits because they can often so easily be prevented with just a little bit of competence and paying attention. For instance, padding placed under pressure points like the elbows, heels, or spine helps prevent nerve compression, ensuring the patient’s head and neck are properly supported can minimize risks to the spinal cord. That does not take a lot of effort. But if the medical team overlooks such steps, injuries such as ulnar neuropathy, sciatic nerve compression, or even spinal cord damage can occur.
In malpractice lawsuits involving positioning injuries, the ability to establish a breach of the standard of care will hingeon medical expert testimony. You need the best medical experts. These experts, usually doctors, will review patient records, surgical notes, and any available imaging to assess if positioning protocols were followed. They can also examine whether the surgical team assessed known patient risks and made necessary accommodations, such as adjusting positioning based on the patient’s unique physical characteristics.
Bringing a Surgical Position Injury Lawsuit
If a member of a surgical team places a patient in an incorrect position that results in injury, the patient may be able to seek compensation. Most meritorious positioning lawsuits are never filed because the patient or the family never fully understands that positioning is what caused the injury or death. So many of these cases are swept under the rug and never see the light of day because the families never even expect negligence. More than most cases, these claims also require a high level of honestly in the medical records to figure out what actually happened. This also leads to less overall lawsuits in these cases.
These cases, like all malpractice claims in Maryland, require the testimony of a medical expert on behalf of the victim who will testify that the doctor breached the standard of care causing an injury or death.
What Impact Settlement Value?
There are a handful of factors that tend to impact the potential settlement value of medical malpractice cases involving surgical positioning negligence, but two tend to be the most impactful. The first and most important factor is the severity of the plaintiff’s injuries. Cases involving more serious injuries with permanent consequences will have a much high settlement value than cases with comparatively moderate injuries.
The other factor that tends to drive settlement value in these cases is whether the defendant is a hospital or a doctor. Hospitals are often more willing to pay to settle cases to protect their public image compared to individual doctors who often care more about their malpractice insurance rates.
Sample Positioning Injury and Death Settlements and Verdicts
Below are a limited sampling of jury verdicts and settlements in surgical positioning cases. One thing is for sure: not a lot of these cases go to trial. These cases are for informational purposes only. It is very hard to approximately the value of these cases based on these results. Every jury and every case is different.
- 2023, Missouri: $125,000 Verdict: A male in his late 60s suffered left ulnar neuropathy when he underwent surgery performed at the defendant hospital. The plaintiff contended that the defendant was negligent for failing to properly position his arm during surgery and for failing to properly pad his elbow during surgery. The defendant denied negligence and contended that the plaintiff’s injuries were due to his preexisting diabetic condition.
- 2022, Illinois: $75,000 Settlement: While undergoing abdominoplasty cosmetic surgery the plaintiff sustained an injury to her peroneal nerve causing left flail foot. The lawsuit claimed that the defendants deviated from the standard of care in failing to properly position her prior to the surgeries, failing to reposition her after the abdominoplasty, and failing to perform the surgeries in stages so as to avoid long operative times.
- 2020, New York: $220,000 Settlement: The plaintiff underwent joint surgery and was sedated for 14 hours. After awakening, she developed numbness and weakness in her right foot. She was diagnosed with foot drop. The lawsuit alleged that the defendants were negligent in failing to properly position her for surgery, resulting in a compression of the sciatic nerve. He further testified that Hicks should have been provided additional lumbar cushioning and gel pads to alleviate pressure.
- 2013, Maryland: $4,750,000 Settlement: Doctors are performing spinal surgery on a toddler and failed to apprise themselves of his motor activity throughout the surgery. When the toddler wakes up from the surgery, he is a quadriplegic. His family sues, alleging that the doctors placed the toddler in an incorrect position that (among other actions) caused his paralysis. Prior to trial, they settled for $4,750,000.
- 2013, Nevada: $1,361,288 Verdict: When doctors are about to operate on a woman, she suddenly falls off the table. She was put in a position with her head down and her feet elevated, and when she falls, she suffers a bulging disc. She feels unusual pain immediately upon waking up. She then sues the hospital, alleging that they lied to her about the injury. The jury awarded her $1,361,288.
- 2007, New York: $750,000 Verdict: A woman presents to a plastic surgeon for a breast augmentation. When she wakes up from the procedure, she loses motion in her right arm. She sues the surgeon claiming that the best explanation is improper positioning during surgery. The jury awards her a verdict of $750,000 after she explained that the injury only permits her to use one hand.
Hiring a Maryland Malpractice Lawyer for Your Claim
Miller & Zois has successfully represented numerous individuals in medical malpractice litigation and has the skills and knowledge, resources and experience to stand up to these doctors when they make mistakes. Call us at 800-553-8082 or get a free online consultation.