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 (presiding Justice Lee Sook-yeon) announced that it recently overturned the lower court's ruling, which 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, patient 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 through non-surgical treatments, the hospital performed a disc removal surgery using a spinal endoscope in May of that year.

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

Despite the procedures, 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 "nerve damage was caused by medical negligence."

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

During the trial, a physical appraiser provided an opinion stating that A's symptoms were consistent with 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 initial 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 did not recognize the hospital's liability, stating, "It is difficult to view that the medical staff failed to fulfill their duty of care, and neurological abnormalities can inevitably occur despite exercising the utmost care due to the characteristics of the surgery."

The appellate court also concluded that the symptoms occurring after surgery were predictable sequelae or complications.

The Supreme Court reversed this decision once again, ruling in favor of A.

Citing established precedent, the Supreme Court stated, "When symptoms that caused severe outcomes arise in a patient during or after surgery, if indirect facts are proven making it difficult to find causes other than medical negligence, the occurrence of such symptoms can be presumed to be based on medical negligence."

The court pointed out that "based on the record, it is difficult to find any objective factor other than the initial surgery that could have caused the symptoms matching cauda equina syndrome in A."

The Supreme Court paid particular attention to the fact that the MRI scan results conducted immediately after A's surgery included notes stating, "Bloody fluid is pooled around the surgical site surrounding the cauda equina, resulting in severe central compression, which requires immediate follow-up observation."

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

However, the surgical records at the time stated that "there were no special events 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 timely implement the necessary medical measures for A.