Spinal cord ischemia complicating treatment of abdominal aortic aneurysms: a legal overview: A rare complication of abdominal aortic surgery and its legal consequences

Giuseppe  Basile; Marcello Ghezzi; Luigi Federico Rinaldi; Chiara Brioschi; Alberto Passeri; Arianna Giorgetti; Enrico Maria Marone

doi:10.23750/abm.v93iS1.12763

Spinal cord ischemia complicating treatment of abdominal aortic aneurysms: a legal overview

A rare complication of abdominal aortic surgery and its legal consequences

Authors

Giuseppe Basile Trauma Surgery IRCCS Orthopaedic Institute Galeazzi, Via Galezzi 4, 20161 Milan, Italy.
Marcello Ghezzi Physician Specialist in General Surgery, Angiology and Vascular Surgery.
Luigi Federico Rinaldi University of Genoa
Chiara Brioschi Vascular Surgery, Policlinico di Monza, Via Amati 111, 20900 Monza, Italy.
Alberto Passeri Legal Medicine; Via Garibaldi 110, 35043 Monselice (PD) – Italy
Arianna Giorgetti Department of Medical and Surgical Sciences, Section of Legal Medicine, University of Bologna, Via Irnerio, 49, 40126 Bologna, Italy.
Enrico Maria Marone Vascular Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia; Director of Vascular Surgery Department, Gruppo Policlinico di Monza, Monza, Italy.

DOI: https://doi.org/10.23750/abm.v93iS1.12763

Keywords:

spinal cord ischemia, vascular surgery, abdominal aortic aneurysm, surgical complications, paraplegia

Abstract

Background and aim: Spinal cord ischemia following open or endovascular aneurysm repair of the abdominal aorta is rare but highly disabling complication. The aim of this work is to report on its occurrence and its legal consequences.

Methods: We report a case of spinal cord ischemia complicating an endovascular aortic repair, its management and sequalae, comparing it with the existing literature and we examine its legal consequences resulting in a malpractice lawsuit and the final decision of the judge.

Results: Although the causal relation between SCI and the neurological deficits reported were assessed by the Court, no element of responsibility imputable to the Hospital or the Medical Staff were found, since the defendant had made every effort to prevent it in the preoperatory setting, and to treat it once it established in the post-operative phase.

Conclusions: predictable but unpreventable complications of necessary interventions rule out medical malpractice, as long as the patient is fully informed about the risks and benefits of the treatment, and provided that in the perioperative setting all due measures are taken in order to prevent it and treat it.

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