Spinal surgery & monitoring

Hobson v Northern Sydney Local Health District [2017] NSWSC 589 was a decision today of Justice Harrison of the NSW Supreme Court. The published catchwords were:

NEGLIGENCE – medical negligence – where plaintiff with Noonan Syndrome rendered paraplegic in surgery to correct spinal deformity and associated respiratory difficulties – where plaintiff’s intraoperative condition deteriorated significantly – where operation halted but not before the plaintiff suffered a spinal stroke that led to paraplegia – whether operation should have been abandoned before this occurred – whether reasonable to continue with operation having regard to plaintiff’s pre-operative condition – whether operation should have been abandoned when spinal monitoring became ineffective following administration of vecuronium to assist ventilation.

During the course of surgery designed to address the effects of an inherited condition including severe lordoscoliosis, Mr Hobson sustained a hypotensive insult to his spinal cord that rendered him a paraplegic. Mr Hobson alleged in general terms that the operation ought to have been aborted earlier when it became apparent that his intraoperative condition was critical and quickly deteriorating. He alleged that he would not have sustained any injury at all if that course had been taken in a timely way.

The lengthy decision dealt with expert evidence in detail. The trial judge also considered arguments in relation to inherent risk (section 5I, Civil Liability Act 2002 (NSW)) and the peer opinion defence (section 5O, Civil Liability Act 2002 (NSW)). Neither were held to assist the defendants.

Judgment was entered for the plaintiff and damages were assessed.


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