Recently, Glenn J. Matera obtained a defense verdict in a neurosurgical case before Judge Steinman in Supreme Court, Nassau County on November 6, 2019. The plaintiff was a 59 year old woman who was found unresponsive at home secondary to a colloid brain cyst. She was admitted to the hospital and underwent surgery for removal of the cyst. She had been placed on sequential compression devices upon presentation to the hospital and after the initial surgery and while she was still unresponsive, she was placed on subcutaneous Heparin 5,000 units as part of DVT prophylaxis. At the time, she also had an external ventricular drain in place. The patient continued to improve and seven days after the surgery, the ventricular drain was removed. The neurosurgeon made a decision at that time to discontinue the Heparin. It was a judgment call with respect to the benefit of keeping the patient on Heparin to guard against a DVT versus a potential bleeding in the brain due to the surgery that was done. There was also the concern that the patient was now up and getting physical therapy and walking and that if she fell while on Heparin, she could also have a spontaneous bleed. At the time of the discontinuance of the Heparin, the order was continued for use of sequential compression stockings.
The patient proceeded to have physical therapy and was out of bed with assistance walking for the next two days and was scheduled to be transferred to a rehabilitation facility when the night before, around midnight, she suffered a massive pulmonary embolism and died. The plaintiff’s attorney’s claim in the case was that the Heparin should never have been discontinued. There was also a claim that the sequential compression stockings should have been utilized more over the next couple of days and that all of this led to the development of the clot. The defendants’ positions were that it was a judgment call with respect to discontinuing the Heparin and that from a neurosurgical standard, it was appropriate at that time to discontinue the Heparin. With respect to the sequential compression devices, it was argued that the more the patient was mobile and out of bed, the less you wanted to put them in the devices which would hinder their ability to be mobile. The sequential compression devices were still being utilized more so at the end of each day when the patient was going to bed but during the day, they were encouraged to be out of bed to chair and to walk and that is why the sequentials were not used as much during that time frame. Plaintiff’s counsel used a neurology expert during the trial, while defense counsel used neurosurgeons. In the end, the jury sided with the defense and rendered a defendant’s verdict in this matter.