Minnesota Case Report: Surgical Negligence During Right Compartmental Fasciotomy Results in Complete Injury to Peroneal Nerve
May 1, 2011
Firm Partner, Brandon Vaughn reached a $150,000 settlement in a surgical negligence case that resulted in an injury to Patient's deep peroneal nerve during the performance of a right compartmental fasciotomy. Read the following Minnesota Association for Justice (MAJ) Minnesota Case Report, Volume 30, Number 1, Summer 2011:
(Excerpts taken with permission from Minnesota Association for Justice (MAJ) “Minnesota Case Reports”)
Patient visited an orthopedic surgeon for the treatment of her compartment syndrome. After evaluation, it was determined that Patient had elevated pressures in both legs and the surgeon recommended that Patient undergo minimally invasive bilateral fasciotomies, to which Patient consented.
Postoperatively Patient was unable to dorsiflex her right foot. On the first postoperative morning Patient had a complete foot drop in her right foot. The surgeon noted that Patient had evidence of injury to the deep peroneal branch of the peroneal nerve. On the second postoperative day, Patient was transferred to a neurosurgery specialist because of her injury.
The neurosurgeon conducted a right peroneal nerve exploration with nerve repair. During the peroneal nerve exploration, the neurosurgeon found a disruption of the deep peroneal nerve and also injury to the superficial peroneal nerve. The neurosurgeon was able to repair the nerve but Patient was still left with motor deficits as a result of her nerve injury and significant pain related to nerve injury. Patient required the use of an ankle-foot orthosis (AFO) daily for several months after her nerve repair, and still wears the AFO as needed for work and recreational activities today. The AFO was required because the Patient experiences a foot drop as a result of the nerve injury.
Approximately two years after the nerve repair the patient has made a good recovery, but not full recovery. Patient still has some difficulty walking long distance and some episodes of neuropathic pain several times a week for short periods of time. The patient also experiences cramping in her third, fourth, and fifth toes when she is exercising.
Liability was strongly contested in this matter. The Patient's expert opined that when performing a minimally invasive fasciotomy, since the peroneal nerve is not visualized it must be protected. In order to protect the peroneal nerve, the surgeon needed to know and identify the anatomical position of the peroneal nerve. The surgeon's failure to protect the peroneal nerve during the fasciotomy caused Patient's peroneal nerve injury. The Defendant surgeon contested liability, and his expert opined performing a fasciotomy involves a blind pass without visualizing the peroneal nerve, and injury to the peroneal nerve is a complication of the procedure. Defendant surgeon's expert opined that "an injury to the nerve is a rare but possible complication of the surgery."
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