We often worry about complications from difficult procedures. What might happen if a patient has anesthesia for 12 hours. Or, operating on a redo-redo cervical spine. And we’re right to be cautious.

But, even simple things can be fraught with hazards; hazards that are easily prevented.

Such an argument is being propelled in Nelson v. Emory Healthcare. The 55 year old patient, Chris Nelson, had blood drawn as part of a wellness exam. He was seated upright on an exam table. Nelson lost consciousness, fell off the table, and was found on the floor, prone, bleeding from his head. It’s not clear from the report whether he fell during the blood draw, or after the venipuncture (when he might have been left alone).

The doctor entered the room, performed a neurological exam, and implemented cervical spine immobilization (given the high index of suspicion for a cervical spine injury).

Once the patient regained consciousness, he complained of tingling in his arms and legs. He was transported to Atlanta Medical Center where he was diagnosed with a broken neck and spinal cord injury.

It’s unclear from the reporting whether his cord injury is complete or partial. It’s also unclear what level his quadriplegia/quadriparesis starts.

What is clear is his plaintiff’s attorney is arguing Nelson will require nearly $5M in economic damages alone – including medical bills and lost wages. That’s before any calculation on pain and suffering.

His lawyer is arguing that it was foreseeable venipuncture could trigger syncope and he should not have been on an exam table. He should have been in a padded chair that would prevent or cushion a fall.

Syncope after blood draw is not unusual.  Losing consciousness after any needle stick happens – this includes Botox, trigger point injections, etc.

We’re right to think about complications after complex procedures. We also need to prevent complications after simple procedures.

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