Concurrent Surgeries & The Orthopedic Surgery Expert Witness

general surgery expert

A Boston jury has determined that a spine surgeon, did not cause his patient’s quadriplegia following surgery in 2012. The surgeon, Chief of orthopedic spine service, performed two complicated surgeries during the same time frame. The patient sued the surgeon for malpractice following an eleven hour surgery that left him paralyzed. The jury concluded that the doctor’s divided attention did not cause the patient’s quadriplegia.

Concerns over concurrent and overlapping surgeries have come to the attention of hospitals and the public. The Senate Finance Committee released a report in December 2016 that calls for a ban on concurrent surgeries and more regulations on overlapping surgeries. The Senate Finance Committee has jurisdiction over the Medicare and Medicaid programs and part of its oversight responsibility is to improve patient safety and transparency. In December 2015, Committee staff became aware of overlapping, concurrent, and simultaneous surgeries reported in a Boston Globe article. The American College of Surgeons Statements on Principles, revised April 12, 2016, found that “A primary attending surgeon’s involvement in concurrent or simultaneous surgeries on two different patients in two different rooms is not appropriate.”

In the case Boston case, the jury found that while the spine surgeon failed to inform the patient that he planned to operate on two patients at once, the jury decided that the doctor’s divided attention did not cause his quadriplegia. Judge Edward Leibensperger instructed jurors that they could only consider whether the medical treatment the patient received “deviated from established standards of care and caused his injury” (Boston Globe, 1/30/2017). Judge Leibensperger is a member of the Business Litigation Session of the Superior Court of Massachusetts.

When the attending surgeon is managing more than one case at the same time, he or she may be away from one of those patients for an extended period of time.  If complications arise, the patient may question whether “double-booking” was an appropriate medical procedure and bring allegations of medical negligence.

A 2019 study published in the Journal of the American Medical Association showed nearly 12 percent of the 66,000 operations studied had some overlap with another case. For the majority of overlapping surgeries, we found no increase in deaths or overall complications compared to surgeries that did not overlap.  A subset of complications — major complications such as stroke and heart attack — were slightly higher.

The study found small increases in deaths and complications for overlapping surgeries involving coronary artery bypass grafting and high-risk patients. In both of these groups, small errors in surgical care could have harmful effects.

 

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