Key Points
- In 2020 a 35-year-old pregnant woman suffered a nerve injury at Canberra Hospital after a spinal needle broke in two, leaving a part of the needle embedded in her back.
- In proceedings which were finally resolved in the Supreme Court of the ACT in 2025 she was awarded $196,173 in damages in respect of the by negligent treatment and care.
What Happened at Canberra Hospital
The patient attended Canberra Hospital for a scheduled caesarean section in 2020. A trainee anaesthetist attempted to insert a long needle into the patient’s back to administer the spinal anaesthetic, however he had difficulty finding a space between the bone and hard ligamentous structures (which is not an uncommon occurrence in such a procedure). However, after several unsuccessful attempts a second, more experienced anaesthetist took over and made a further attempt using the same needle. After withdrawing it she saw that the end of the needle had broken off in the patient.
A neurologist quickly arrived to dissect and remove the needle, however the patient developed symptoms of nerve injury suggesting that the ordeal had caused irritation and injury to the spinal nerve root. The injury, though relatively minor, had a profound impact on her childbirth experience and caused her to develop psychological symptoms and ongoing pain in her back and down her legs.
The Legal Case – Proper Standard of Care
The patient brought a claim against the hospital for medical negligence, seeking compensation for the injury it had caused.
It is a known risk that spinal needles might break during procedures, especially if there is difficulty placing the needle, but it is generally considered unsafe to attempt multiple passes with the same needle. With each impact on hard surface (like bone), the body of the needle may become weaker and the risk of the needle breaking increases.
The court grappled with the standard of care in such situation, particularly whether the failure to change to a fresh needle in this case amounted to negligence, given that the medical profession was unable to say clearly how many passes with the same spinal needle was acceptable practice.
The first anaesthetist, who was a trainee working appropriately under supervision, had felt the needle impact on hard structures (either the bone or ligamentous material) several times before handing it off to the senior anaesthetist. The senior anaesthetist did not know how much pressure the first doctor had applied, how many minor re-directions he had made, or how often he had appreciated an impact on bone or hard structures.
The two anaesthetists together could not say exactly how many passes they made, but believed it was no more than 3 or 4. Independent medical experts had agreed that 3-4 passes with the same needle was probably reasonable, but there was a grey area where some situations would call for an earlier change of needle. The individual circumstances of the case, how much force was applied, and the “feedback” by touch felt during each pass would inform the doctor’s decision about when to change to a fresh needle.
In taking over, the senior anaesthetist had not directly appreciated these nuances, therefore it would have been an appropriate precaution to open a fresh needle.
Court Findings: A Preventable Risk
It was ultimately decided by the court that the risk of the spinal needle breaking, whilst “very rare”, was reasonably foreseeable and had the potential for causing serious injury. Additionally, the precaution against such a risk was readily available and easily implemented without burdensome cost – replacing the needle with a new one. With all these factors in consideration, the court found that the needle should have been replaced, and the failure to do so was negligent.
Why This Case Matters
The proper standard of care in medical procedures is a complex and nuanced issue. There can be situations where the right call depends on individual circumstances of the case, and often the answer is not straightforward. Not all medical mistakes reach the level of negligence.
Get Legal Advice if You’ve Been Injured
Where a patient has suffered an injury or complication during a procedure, it is important to get prompt legal advice about the potential to make a claim.
If you or someone you know has experienced an injury during surgery or medical care, please contact us for a confidential consultation.
DISCLAIMER
This article reflects the current law at the time of publication. It is intended for informational purposes only and does not constitute legal advice. The actual decisions in each case are summarised for general understanding. For specific legal guidance in relation to your situation, please consult with a qualified legal professional.