The Plaintiff, a woman with a long history of back problems, was referred to the Defendant, a Consultant Orthopaedic Surgeon who performed a spinal fusion which involved the insertion of an inter-body cage and pedicle screws. The following year the Plaintiff experienced severe pain and an MRI and a CT scan was obtained which showed that part of the insertion from the spinal fusion surgery had been displaced. The Defendant performed a revision procedure the following year with some revision of the fusion and removal of one of the screws in an attempt to remove the inter body cage. This complicated procedure led to the development of a Dural tear with a cerebrospinal fluid (CSF) leak and she lost power in her legs and sensation in the perineal area following surgery. The Plaintiff developed cauda equina syndrome, a condition due to damage to the bundle of nerves below the end of the spinal cord, and was referred to a new consultant neurosurgeon.

She underwent repeat MRI and CT scans again that year and was referred then to a third neurosurgeon who advised that the cage had extruded into the canal causing compression of the nerve roots. She was informed at this appointment that she required further complicated and risky surgery. She subsequently underwent an L4 S1 posterior fusion, decompression and removal of the L4 / 5 cage. She then had repeated wound revision procedures due to the CSF leak management. She was discharged from hospital more than two months after the procedure and has since required considerable medical input simply to be able to live her daily life semi-independently.

An expert report was prepared by a Consultant Spinal Surgeon to deal with the issue of liability. It was the Plaintiff’s case that that the spinal fusion procedure that the plaintiff underwent was not performed to the standard one could reasonably expect of a consultant orthopaedic surgeon. As a result of the misplaced L4 screws the L4 / L5 segment was unstable leading to micro motion at that level causing the intra-discal device to extrude into the spinal canal causing significant damage to the cauda equina. It was also claimed that the revision surgery attempted by the Defendant was performed to an unacceptable standard.   

Proceedings were issued in the matter in December 2013 and the matter was ultimately fixed for Trial with the Defendants placing full proof of liability on the Plaintiff. Ultimately a mediation took place shortly before the Trial and the matter resolved in the sum of €1.6 million and costs.

If you have any further queries, please contact Damien Conroy, Partner in our General Litigation Group.


03 January 2019

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