Daniel E. Holloway
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Scottish Rite complaint alleges post-operative hypotension was not timely treated after scoliosis surgery before quadriplegia

The complaint alleges that a surgeon performed an elective multi-level spinal fusion for scoliosis on a 16-year-old patient at Scottish Rite Children’s Medical Center. The surgery appears to have lasted about 8.5 hours. A brief loss of motor function during it appears to have resolved after a spinal rod was released. Afterward her blood pressure dropped and stayed low for hours despite a saline bolus and norepinephrine. By around midnight she had lost motor function in all four limbs. The complaint alleges that untimely treatment of her low blood pressure and no timely cervical spine intervention caused permanent loss of function in her limbs.

System
Children’s Healthcare of Atlanta
Facility
Scottish Rite Children’s Medical Center
Providers involved
Children’s Healthcare of Atlanta, Inc. / Scottish Rite Children’s Medical Center, Inc. / Children’s Physician Group Specialty Providers, LLC / Neonatology Associates of Atlanta, PC / Pediatrix Medical Group of Georgia, PC / Mednax Services, Inc. / Otobong I. Udoudoh, NP / Lindsay Sikora, M.D. / Jorge A. Fabregas, M.D. / Joshua J. Chern, M.D.
Pattern
Alleged failure to promptly treat post-operative hypotension after elective scoliosis surgery
Harm
Alleged permanent paralysis of the arms and legs from a spinal cord injury

Overview

This page concerns a public complaint alleging that hospital staff and physicians did not treat significant hypotension quickly enough after a teenager’s scoliosis surgery.

Chronology

The complaint alleges as follows:

  1. On January 31, 2020, Dr. Fabregas performed an elective multi-level spinal fusion for scoliosis on the patient, then 16 years old, at Scottish Rite.
  2. The surgery appears to have lasted about 8.5 hours. A transient loss of motor function during it appears to have resolved after a spinal rod was released.
  3. At about 8:54 p.m. that evening, nurses recorded a blood pressure of 81/45, and her pressure remained low over the next several hours.
  4. A saline bolus and a call to nurse practitioner Otobong Udoudoh followed, but the low blood pressure did not significantly improve.
  5. Norepinephrine was ordered at 9:56 p.m. but not given until 10:06 p.m. The dose was lowered twice despite what the complaint calls persistently low pressures until midnight.
  6. Around midnight, an orthopedic resident found the patient had lost motor function in all four limbs. Dr. Sikora, the intensivist, is not noted at the bedside at 12:15 a.m.
  7. Early on February 1, 2020, Dr. Fabregas and Dr. Chern chose to re-explore the original surgical site rather than the cervical spine.

Alleged failures

The complaint alleges the following failures:

  • Nurses did not act quickly enough on the patient’s post-operative hypotension with fluid boluses and pressor medication.
  • Nurse practitioner Udoudoh did not require the attending physician’s immediate attendance when the plan of care was not timely changed for a cervical spine issue.
  • Dr. Fabregas and Dr. Chern chose to re-explore the surgical site rather than order a spinal angiogram or treat the cervical spine.
  • The complaint pleads medical malpractice and vicarious liability against the defendants, and attaches expert affidavits under O.C.G.A. § 9-11-9.1. It also seeks attorney’s fees under O.C.G.A. § 13-6-11, alleging bad faith and withheld medical records.

Entities and tags

Children’s Healthcare of Atlanta, Inc.Scottish Rite Children’s Medical Center, Inc.Jorge A. Fabregas, M.D.Joshua J. Chern, M.D.Lindsay Sikora, M.D.Otobong I. Udoudoh, NPSpinal fusionHypotensionDelayed or missed diagnosisDelayed treatmentPost-operative complicationsFailure to monitorBrain or spine injuryOrthopedic surgeryNeurosurgeryCritical care medicineNursing