Supreme Court Rules Hospital Must Compensate Patient for Bowel Dysfunction After Spine Surgery

The Supreme Court has ruled that a hospital must compensate a patient who suffered from side effects such as bowel dysfunction following back surgery.

The Supreme Court's Third Division, presided over by Justice Lee Sook-yeon, recently overturned a lower court ruling that had dismissed the damages lawsuit filed by a patient, identified as A, against a hospital operator, identified as B, and sent the case back to the Seoul High Court.

In April 2018, A visited B's hospital complaining of lower back pain and leg numbness.

After diagnosing A with a herniated lumbar disc at the second and third lumbar vertebrae and failing to see improvement with conservative treatment, the hospital performed a lumbar disc removal using a spinal endoscope in May of that year.

A continued to experience leg numbness, paralysis, tailbone pain, and bowel dysfunction, prompting the hospital to perform follow-up surgery in June.

Even after the second procedure, A's symptoms did not disappear.

Eventually, A had to transfer to another hospital for treatment and filed a lawsuit against B in March 2023, claiming that medical negligence caused nerve damage.

The first instance court recognized medical negligence by the hospital staff and ordered B to pay approximately 120 million won to A.

During the trial, a medical evaluator stated that A's symptoms corresponded to cauda equina syndrome.

This condition occurs when the bundle of nerves resembling a horse's tail at the base of the spinal cord is compressed.

Based on the fact that new symptoms, such as bowel dysfunction, developed after the first surgery, the trial court noted that it could be inferred that medical malpractice occurred while the medical staff manipulated endoscopic instruments during the operation.

However, the second instance court ruled against the hospital's liability, stating that it was difficult to conclude the medical staff failed in their duty of care, and that neurological abnormalities can inevitably occur due to the nature of the surgery even when exercising utmost care.

It also concluded that the symptoms occurring after surgery were foreseeable sequelae or complications.

The Supreme Court reversed this decision once again, siding with A.

The Supreme Court cited established precedent stating that when severe symptoms causing a serious outcome occur in a patient during or after surgery, and indirect facts are proven making it difficult to attribute the cause to anything other than medical malpractice, the symptoms can be presumed to be due to medical negligence.

The court pointed out that, according to the records, it was difficult to find any objective cause other than the initial surgery for the symptoms corresponding to cauda equina syndrome that appeared in A.

The Supreme Court paid particular attention to the MRI scan report conducted immediately after A's surgery, which noted that "bloody fluid has accumulated and surrounds the cauda equina around the surgical site, resulting in severe central compression that requires immediate follow-up observation."

Considering this, the court pointed out that A developed neurological compression symptoms due to a hematoma after surgery, and that reoperation or other urgent measures were necessary.

However, the surgical records at the time stated that "there were no special incidents during the surgery and the patient's condition was stable," while the nursing records noted that "the attending physician explained that the surgery went well with no specific findings."

Based on these findings, the Supreme Court ruled that the medical staff failed to provide timely medical treatment necessary for A.
※ Please note: This article was translated by AI and may contain errors.