The family of a patient who suffered paralysis and death after shoulder surgery sued the surgeon, arguing that he should have ordered an MRI of the man's cervical spine when diagnosing his shoulder pain. But a Virginia jury sided with the surgeon in the wrongful death lawsuit, finding that he provided adequate care despite the patient's death.

In a 2005 lawsuit, Barry Sarver's family alleged that B. Joseph Prud'homme, MD, didn't diagnose a large cervical disc herniation that caused spinal cord compression, quadriplegia and eventually a loss of the ability to speak or breathe without assistance, according to JAS Publications, a court reporting service.

Mr. Sarver was a 49-year-old park ranger who in 2003 went to see Dr. Prud'homme, then based in Blacksburg, Va., complaining of shoulder and upper back pain. Dr. Prud'homme diagnosed osteoarthritis of the cervical spine and tendonitis of the subscapularis tendon. His diagnosis was based in part on an MRI of the left shoulder but not the cervical spine, according to the court reporting service.

On the day of surgery, Mr. Sarver received an interscalene nerve block before Dr. Prud'homme performed the decompression procedure. After surgery, according to the court reporting service, Mr. Sarver said he couldn't move his extremities. The anesthesia provider said that the paralysis was a temporary complication. But Mr. Sarver's paralysis continued.

An MRI performed in the hospital showed that a large herniation was pressing on the spinal cord at the C5-C6 level. Even after emergency spine surgery, Mr. Sarver remained paralyzed and had trouble breathing on his own. After his condition worsened over the next few weeks, he was removed from life support and died about a month after the first surgery.

According to the court reporting service, the Sarver family attorney claimed that Mr. Sarver was not properly positioned during the decompression surgery and that had caused the damage to the spinal cord. If Dr. Prud'homme would have ordered an MRI of the cervical spine before surgery, he would have seen the herniation, alleged the attorney, who did not return a request for comment for this article.

During the trial in September 2010, Dr. Prud'homme, his attorneys and expert witnesses argued that Mr. Sarver received appropriate care and that the large disc herniation that appeared in the post-op MRI was caused by the normal stress of the surgery and intubation and extubation. After deliberating for 2 hours, the jury announced that it agreed with the surgeon that Mr. Sarver did receive adequate care, regardless of the unforeseen outcome.

"It was a one-in-a-million event. No one could have foreseen what happened," Dr. Prud'homme's attorney, Walter Herbert Peake III, told Outpatient Surgery Magazine. "We're glad that the jury understood that."

Dr. Prud'homme, who now practices in West Virginia, declined to comment.

Kent Steinriede