An Arizona medical malpractice jury awarded Plaintiff Sharon King $5.29 million in early December 2023. after a week-long trial, that her Arizona medical malpractice attorney described as “the largest medical malpractice verdict in Pima County [Arizona] in the last five years.”
King had gone to Oro Valley Hospital for shoulder replacement surgery (total shoulder arthroplasty) in September 2020 that was performed by Dr. Andrew Smith of Northwest Allied Physicians. According to King, “He tied off my axillary artery and neurovascular bundle, which in turn caused me to have to have amputation … He has altered and changed my life forever … I don’t think any amount of money is enough for a lost limb … I hope he loses his license, first of all. Second of all, if he doesn’t lose his license, that it’s mandatory that he goes back to school.”
“Having two arms, people can do just about anything. Wash their hair, get shampoo out of the pump bottle, opening a water bottle … I’m hoping to get with my prosthetic company and have a prosthetic hopefully made. I don’t have much use at all of my upper limb so a lot more tests are gonna have to be run to see if that’s possible but I’m hoping for an arm.”
Dr. Smith reportedly admitted his liability before trial.
A medical article published in February 2020 reported: “Total shoulder arthroplasty (TSA) is a very safe procedure, with an in-hospital mortality rate of just 0.09%. The complications of TSA are commonly described as prosthetic loosening, glenohumeral instability, periprosthetic fracture, infection, rotator cuff tear, nerve damage, and deltoid dysfunction,. Very rarely are more serious complications described in the literature, such as brachial plexus injury or axillary artery damage. Even outside of TSA, damage to the axillary artery is rare and overwhelmingly described in the literature as a consequence of shoulder dislocation. When it is discussed in conjunction with shoulder arthroplasty, most of the literature states that damage to the axillary artery is a risk during reverse shoulder arthroplasty, with a paucity of information available about the risk during anatomic TSA. In fact, our literature review could identify only 2 cases that described axillary artery injuries occurring during TSA. Similarly, brachial plexus injuries during TSA are very rarely encountered in the literature.”
The author concluded: “We have presented the case of a 79-year-old patient who underwent a TSA and had iatrogenic axillary artery and brachial plexus injury, from a threaded Steinmann pin, that was not recognized postoperatively for at least 24 hours. Delayed revascularization led to systemic distribution of rhabdomyolysis products, multisystem organ dysfunction, and death. This case highlights the importance of proper case selection, regional pathoanatomic knowledge, preoperative image analysis, relevant surgical training and skills, hypervigilant neurovascular monitoring after shoulder arthroplasty with interscalene blocks, and the option of amputation if early revascularization is not possible. It demonstrates the potential danger of regional nerve blocks, complex surgical procedures performed by low-volume surgeons, and deviation from well-established revascularization protocols.”
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