A patient fractured his cervical vertebrae (the result of a horseback riding accident) but was neurologically intact. The surgeon evaluated the patient and performed a posterior cervical fusion to reduce the fracture and stabilize the neck. As a result, the patient remained neurologically intact without any deficits. The neurosurgeon instructed the patient to return to normal activities three months-postop and the neurosurgeon discharged the patient after several months of follow-up.

The following year, the patient sought the services of a chiropractor to address persistent, mild cervical pain. The findings of a neck x-ray, taken as part of the routine chiropractic exam, indicated one of the screws in the fusion construct had backed out a few millimeters. The x-ray also confirmed a solid cervical fusion, the original goal of the surgery. The chiropractor referred the case to another neurosurgeon. This physician performed a second procedure on the patient; an anterior fusion. The cervical discomfort was essentially unchanged.

The patient sought legal counsel and filed a malpractice claim against the first surgeon. The second neurosurgeon served as the expert witness, certifying the merit of claim on behalf of the plaintiff. This expert was previously disciplined by a national professional medical society for violating its code of ethics while delivering testimony as an expert witness in the past.

The plaintiff dropped the case prior to trial, but not before the professional liability carrier spent over $30,000 on defense. The American College of Surgeons censured the expert for his testimony in this case.

Conclusion:
Medical Justice® Patient-Physician Agreements, had they been implemented by the original physician, would have foreclosed the sole expert witness from testifying for the plaintiff. Why? The expert was not a member in good standing of the neurosurgeon’s professional society.

Medical Justice Agreements mandate that should the patient advance a dispute, both the plaintiff and defendant will only use experts who are members of and follow the code of ethics of the treating doctor’s professional medical society. This expert witness had been expelled from the defendant physician’s professional society. While effective action was taken, the prior use of Medical Justice Patient-Physician Agreements would likely have prevented the filing of such a case in the first place. Further, had such an Agreement been in place, the original surgeon would have been able to file a counterclaim against the plaintiff for breaching the contract by hiring an expert witness not in good standing in his professional society.