Young Woman Suffers Significant Visual Impairment as a Result of a Failure to Timely Correct a Shunt Malfunction
A young girl began suffering from hydrocephalus, which is a condition where the cerebral spinal fluid does not drain properly and began building up in her brain. In order to treat her condition, the doctors surgically inserted a shunt into her skull that allowed the excess cerebral spinal fluid to drain away harmlessly. As a result, the young girl recovered from the visual losses she had sustained from the build-up and she resumed her normal life.
Several years later, when she was now a young adult, she again began to have problems with headaches and other symptoms. When she went to the emergency room she was diagnosed with having a condition called Arnold Chiari malformation, which interrupts the flow of the cerebral spinal fluid. The neurosurgeon assigned to her case performed a brief surgery to correct the problem.
Plaintiff’s investigation showed that before the woman was discharged from the hospital the nurse noted that the young woman’s right eye was deviating, or turning inward. Plaintiff’s investigation showed that this is a sign of a buildup of excess cerebral spinal fluid in the young woman’s brain. In other words, her shunt was not working. A CT-scan was ordered, which showed a slight change in her condition from when she first came to the hospital. Plaintiff’s investigation showed that in these circumstances, even a slight change in the CT-scan is significant and required further workup. Despite these findings, she was discharged. At no time during the hospitalization was any attempt made to evaluate the function of the young woman’s shunt.
The young woman continued to have the deviation of her eye and increasing head pain. After less than two miserable days at home, she returned to the emergency room of the same hospital. By this time both eyes were deviating inward, an unmistakable sign of pressure on the cranial nerve, the plaintiff’s investigation showed that this was likely from increased cerebral spinal fluid. Still, the emergency room physicians and the neurologists and the neurosurgeons who saw her did not test the function of the young woman’s shunt.
While the health professionals did attempt to obtain a spinal tap, which would provide an initial spinal pressure and reduce the amount of cerebral spinal fluid in the young woman’s brain, that attempt was unsuccessful reportedly because the Level I Trauma Center did not have a needle of the proper size. Plaintiff’s investigation showed however that the proper size needle was available in another part of the hospital.
Two days (a weekend) was allowed to go by before another attempt was made, by a different set of doctors who had the correct sized needle the entire time. When the tap was finally performed it showed a significantly elevated pressure. Plaintiff’s investigation showed that although the original order for the tap called for the removal of a significant amount of fluid so as to reduce the pressure on the young woman’s brain, the tap when finally performed did not remove anywhere near the amount of fluid originally requested because the original order was not communicated to the doctor who actually performed the spinal tap. Still, the health professionals did not attempt to evaluate the function of the young woman’s shunt despite all of the evidence of excess cerebral spinal fluid in her brain.
Even after the abnormal lumbar puncture result, it was another two days before the health professionals finally took the woman to surgery. In the meantime, her vision was getting progressively worse. While she had some vision when she came to the emergency room the second time, by the time that she was taken for the surgery to correct her shunt the plaintiff’s investigation showed that she had lost all of her vision in both eyes. Just prior to starting the surgery the neurosurgeon checked the function of the young woman’s shunt by using the simple test that had been available the entire time: he pressed on the reservoir located behind her ear and noted that it did not refill as it should. This indicated that the shunt was not draining the cerebral spinal fluid properly. Once the surgeon corrected the problem with the shunt, the cerebral fluid followed through it without difficulty.
Unfortunately for the young woman, her vision did not recover well. Long after the surgery, the woman remains blind in one eye and can see almost nothing, even with the use of assistive devices, in the other eye. Despite her disability, she has been able to obtain her Master’s Degree in Social Work.
Plaintiff agreed to negotiate this matter prior to trial at mediation. The case settled during the mediation with the health professional and hospital.