A lawsuit brought by a Dundalk woman who claimed she lost use of her right arm after an orthopedic surgery procedure was dismissed last month on the same day it was scheduled to go to trial in Baltimore County Circuit Court.
Lawyers for Donna McNeal and Dr. David B. Lumsden agreed to dismiss with prejudice the medical malpractice case Aug. 25, the same day the trial was to start.
E. Philip Franke III, who represented Lumsden and Orthopedic & Hand Surgery Associates P.A., said the case had been “resolved” and that his clients had been dismissed. Franke, of Baxter, Baker, Sidle, Conn & Jones P.A. in Baltimore, declined further comment.
H. Briggs Bedigian, McNeal’s lawyer from The Law Offices of Wais & Vogelstein in Owings Mills, also declined to comment on the case.
The lawsuit, filed in January 2006, alleges McNeal developed complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy. McNeal described the pain in her upper extremities, particularly her right arm, as “cold, sharp, pins and needles, throbbing, burning, under armpit feels like thousands of bees stinging.”
Hard to identify
The neurological condition causes nerves to “send constant pain signals to the brain” and is characterized by a severe, burning pain and tissue swelling, according to the Reflex Sympathetic Dystrophy Syndrome Association, a national advocacy group. Between 200,000 and 1.2 million people are affected by the condition, according to the association. It can be brought on by any type of “traumatic” injury from sprains to falls to accidents, the RSDSA says.
The condition is often seen following surgery to treat carpal tunnel syndrome, said Steven E. Goren, a Michigan lawyer who handles CRPS cases. But identifying the nerve condition can be difficult following surgery because surgery by definition involves injuring nerves, he said.
Different doctors can also come to different conclusions about what is causing a patient’s pain, Goren added.
“It’s a diagnosis of exclusion,” he said.
McNeal first saw Lumsden in late January 2003 complaining of neck, hand and elbow pain as well as “tingling” in her hands, according to the lawsuit. A previous doctor had diagnosed tendonitis; Lumsden determined McNeal had tennis elbow and possibly nerve damage in her neck, the complaint said.
Lumsden recommended finger and hand braces, limited activities and heat and ice as the initial treatments, and McNeal declined injections, according to the lawsuit, which does not specify the type and location of the injections.
McNeal returned to Lumsden two weeks later experiencing the same problems and again declined injections but agreed to undergo surgery involving manipulating the joints and receiving injections while under anesthesia, according to the complaint.
Following the Feb. 25, 2006, surgery, McNeal awoke with pain in her elbows and was unable to move her arms or straighten her fingers, the lawsuit says. McNeal was still feeling pain, particularly in her right arm, during a follow-up exam three days later, according to the lawsuit.
Lumsden gave McNeal a sling and noted the possibility of CRPS. By the end of March, Lumsden had prescribed formal physical therapy and painkillers for McNeal while recommending she see pain specialists who ultimately diagnosed CRPS, according to the lawsuit.
Causation an issue
McNeal has been unable to return to her job as a data entry clerk and suffers from pain in all of the joints in her right arm, according to the lawsuit.
In court filings, Franke argued Lumsden took a conservative approach in caring for McNeal and that the doctor found stable joints and no abnormalities when he performed the procedure. An orthopedic surgeon serving as a defense expert witness said he found no medical literature showing a patient developing CRPS following the common procedure Lumsden performed, Franke said, adding the plaintiff’s expert witness reached a similar conclusion.
R. Steven Shisler, a Philadelphia lawyer who specializes in CRPS cases, said such medical malpractice cases can be difficult to prove because it can be unclear if the condition existed before or was a result of surgery.
“Causation is always an issue in a medical malpractice case involving CRPS,” he said.