In the U.S., roughly 288,000 people are presently living with a type of spinal cord injury. There are roughly 17,700 new spinal cord injuries each year, many of which are very debilitating. Carlos Ayala brought a medical malpractice case in Union County, New Jersey after undergoing a spinal surgery that did not go as planned. A jury recently awarded him $4.5 million in the case of Ayala v. Friedlander, M.D., from which he will recover $2.25 million based on the terms negotiated in a high-low agreement.
Ayala's procedure was performed by defendants Marvin Friedlander M.D., a neurosurgeon, and Douglas Bradley, M.D., an orthopedic surgeon. The defendants were alleged to have failed to adhere to the standards of care in diagnosis and in surgery when a screw was improperly positioned. During this lumbar fusion procedure, the improper positioning of a pedicle screw caused Ayala to endure significant pain, numbness, and weakness due to its position in the L5 nerve root. The doctors are further accused of failing to conduct an MRI or CT, which would have detected the problem. A remedial surgery was required roughly two years after the initial procedure.
Prior Work Injury
Ayala had originally incurred a work injury while repairing a forklift that caused notable damage to his L5-S1 discs. Ayala chose to undergo the fusion procedure after it appeared that he was not making enough progress in order to return to work. During the four-week trial, the defense explained that Ayala's symptoms were not what is typically seen when a pedicle screw is improperly positioned and adversely impacting the nerve root. The defense also suggested an alternate theory that the symptoms he exhibited were the result of the traction used in the procedure.
Prior to the jury verdict and award, the parties entered into a contract known as a high-low settlement agreement. These agreements are often made to limit overall financial risk by establishing a minimum and maximum amount that is recoverable. Defendants wishing to minimize the risk of facing a massive award, or a plaintiff fearing a strike motion to their award may be open to these negotiations. For example, if a jury awards $2 million and a high-low agreement is established with a $300,000 minimum and $1 million maximum, then $1 million is what the plaintiff will receive. In this case, although the jury awarded $4.5 million, the maximum recoverable was $2.25 million.
The fusion process is designed to connect two or more spinal vertebrae. Typically, bone or an artificial material is used for spacing. To secure the fused parts, screws and rods may be employed to hold everything together. As with any such spinal procedure, there is the possibility of life-altering results when it is not successful.
The usage of pedicle screws is to provide needed strength to the fusion process. They are often placed on opposite sides of the section of fused vertebrae. A rod is also commonly used that connects the screws, all of which may or may not need to be removed.