Surgical Implant: Nurse Should Have Sought Review of Surgeon's Choice of Product
Legal Eagle Eye Newsletter for the Nursing Profession
August 1998
Quick Summary: The hospital’s nurse was negligent to order the implant for a neurosurgeon to use in spinal fusion procedures at the hospital, without the nurse seeking review of that decision through internal administrative channels within the hospital.
According to the medical expert witnesses, it was negligent for the neurosurgeon to use this implant rather than human tissue. UNITED STATES COURT OF APPEALS, EIGHTH CIRCUIT, 1998.
The neurosurgeon decided not to use bone harvested from the patient’s own hip and not to use bone material from a tissue bank, but instead to implant a specific artificial material called Orthoblock during an anterior cervical diskectomy and fusion surgery.
According to the U.S. Circuit Court of Appeals for the Eighth Circuit, the patient continued to experience difficulty, and had the surgery re-done four months later by a surgeon who removed the Orthoblock and replaced it with bone from the patient’s hip.
The patient sued the first surgeon and the first hospital for malpractice. The medical expert witnesses stated it was beneath the appropriate standard of care for surgical practice to use this material rather than human bone.
The court accepted the expert testimony against the first surgeon. The court went on to rule the first hospital was also legally liable, because the hospital’s nurse had ordered this specific synthetic implant for the surgeon’s use, on the surgeon’s orders, without the nurse having sought review of the surgeon’s decision through administrative channels within the hospital.
The court noted that the last version of the package insert for this specific implant being printed before the surgery in question indicated it was not to be used, "... in any position where it would be likely to sustain significant tensile, flexural or other shear forces during function." The first version of the package insert printed after the surgery specifically contraindicated it for spinal procedures.
Hall v. Arthur, 141 F. 3d 844 (8th Cir., 1998).