Brachial Plexus Injury Post Mastectomy

Case Overview
Patient diagnosed with breast cancer. Two months later underwent a bilateral mastectomy with deep tissue reconstruction. Pt couldn’t move arms. Back to surgery from clotting of left breast and within 10 hours-had to re-vascularize the breast. Functional use came back fully on left side, right side has yet to come back. Limited ROM in left arm- she suffered brachial plexus injury which change in nerve function and circulation. No function in certain fingers, nerve pain from shoulder to hand and on max dose of gabapentin. Went to OT who told her this was brachial compression injury based on original position placed during surgery.

Issue
Negligence with causation?

MEDQUEST EXPERT RESPONSES:

From the limited info sounds like a hyperextension injury that occurs during surgery if the arms are not protected which can cause these issues. Other possibility is that the brachial plexus was in the surgical field and perhaps injured during axillary node surgery if that was done in this case.
Dr. DK – Breast Surgeon

Sounds meritorious and worthy of review.
Dr ML – Breast Surgeon

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