Supreme Court Rules Hospital Must Compensate Patient for Bowel Dysfunction Following Back Surgery

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

The Supreme Court's Third Division, led by Justice Lee Sook-yeon, announced recently that it reversed the lower court's ruling against the plaintiff in a 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, patient A visited B's hospital complaining of symptoms such as lower back pain and leg numbness.

The hospital diagnosed A with a herniated lumbar disc (between the second and third lumbar vertebrae) and provided non-surgical treatment. When the symptoms did not improve, the hospital performed a lumbar disc removal surgery using a spinal endoscope in May of that year.

Following the procedure, A continued to complain of leg numbness and paralysis, tailbone pain, and bowel dysfunction, prompting the hospital to perform a follow-up surgery in June.

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

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

The first trial recognized medical negligence on the part of the hospital and ordered operator B to pay approximately 120 million won to patient A.

During the trial, a medical appraiser 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 in A after the initial surgery, the court pointed out that it can be inferred that medical malpractice occurred while the medical staff was manipulating the endoscopic instruments during the operation.

However, the second trial overturned this, stating that it was difficult to view the medical staff as having failed to fulfill their duty of care, and that neurological abnormalities can inevitably occur due to the nature of the surgery even when exercising the utmost care.

The appellate court also judged that the symptoms arising after surgery were foreseeable sequelae or complications.

The Supreme Court overturned the appellate ruling once again, siding with patient A.

The Supreme Court cited existing legal precedent stating that if a serious condition causing a severe outcome occurs in a patient during or after surgery, and indirect facts are proven making it difficult to find any cause other than medical negligence, the condition can be presumed to be due to medical malpractice.

The court noted that, according to the records, it was difficult to find any objective factor other than the initial surgery to explain the symptoms matching cauda equina syndrome that appeared in A.

The Supreme Court particularly focused on the MRI (magnetic resonance imaging) scan results performed immediately after A's surgery, which stated, "Bloody fluid has accumulated around the surgical site, surrounding the cauda equina, resulting in severe central compression and requiring immediate clinical observation."

Taking this into account, the court pointed out that A experienced nerve compression symptoms due to a hematoma after surgery and urgently needed reoperation.

However, the surgical record at the time stated that "there were no special events during the surgery and the patient's condition was stable," while the nursing record noted that "the attending physician explained that the surgery went well without any specific findings."

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