Pennsylvania jury awards $24M record verdict to man injured during spinal surgery
Key Takeaways
A Pennsylvania jury has awarded nearly $24 million, the largest medical malpractice verdict in county history, to a man who was injured during spinal surgery.
A screw was mistakenly placed in the man’s spinal cord during surgery, leading to significant loss of mobility.
James Spangler of Manchester, Pennsylvania, had spinal surgery at WellSpan York Hospital in October 2019.[][] During the procedure, neurosurgeon Joseph Krzeminski, MD, mistakenly inserted a screw into Spangler’s spinal cord.
Spangler reportedly developed a permanent and disabling injury as a result.[] In September 2024, a York County, Pennsylvania, jury ruled in favor of Spangler. They found WellSpan York Hospital and Dr. Krzeminski liable for Spangler’s injuries, and awarded him nearly $24 million.
Before his surgery, Spangler spent 26 years working as a mechanic.[] His October 2019 procedure was a laminoplasty to address spinal stenosis. Dr. Krzeminski performed Spangler’s surgery and reportedly inserted a screw into Spangler’s spinal cord. Reportedly, despite an intraoperative monitoring system detecting the error and alerting Dr. Krzeminski, the procedure was not stopped or altered.[]
Surgery aftermath
Spangler woke up from surgery unable to move. He developed significant spinal damage. Records show that it took 22 hours before he received a second surgery to remove the screw.[]
After years of physical therapy, Spangler regained only limited mobility. He is still experiencing difficulty walking and other disabling effects of spinal damage. Spangler is now 58.[]
Going to trial
Dr. Krzeminski has retired from WellSpan York Hospital, but was still named as a defendant in the malpractice suit filed by Spangler. The case went to trial in September 2024. After 8 days of trial, the jury unanimously ruled in favor of Spangler in an hour.[]
The jury awarded Spangler $23.87 million. The verdict is the largest sum ever awarded in a medical malpractice case in York county, more than tripling the previous highest award sum. In a press release, attorney Iddo Harel of Ross Feller Casey law firm, who represented Spangler, commented that the high-dollar award reflects the significance of Spanger’s injury and the severity of WellSpan York Hospital’s alleged negligence.[]
“The notion that mid-state juries won’t award substantial damages in medical malpractice cases is just wrong. Jurors across Pennsylvania will respond if the case is legitimate and is presented to them in the right way,” Harel said. “The case was as much about credibility as it was about neurosurgery. The jury’s prompt and unanimous decision reflects the profound impact this negligence has had on Mr. Spangler and his family — and the need for accountability in our healthcare system.”[]
In a statement, WellSpan Health expressed disappointment with the verdict, but did not provide further comment.[]
“We are disappointed in the verdict given the evidence that was presented. Options for appeal are being reviewed and therefore we will not comment further on active litigation. WellSpan Health remains fully committed to providing safe, high-quality care for all of our patients.”
Spinal surgery risks and complications
Paralysis and other significant neurological damage are some of the most severe complications linked to spinal surgeries. The exact rate varies by study and type of spinal surgery, but most data shows a downward trend in the past few decades. However, these complications are still a prominent concern for many patients and surgeons.
Neurosurgeon Joel S. Beckett, of DISC Sports and Spine Center in California, said,
“In spine surgery, we are particularly concerned about the potential for neurological injury, as damage to the spinal cord or nerves can result in weakness, paralysis, or loss of sensation.”
In addition to serious injuries to the spinal cord, spinal surgeries can cause dural tears that can lead to cerebrospinal fluid leak. These surgeries also carry the risks associated with nearly all surgeries, including infection, blood clots, bleeding, anesthesia reactions, and cardiac arrest. Hany Demian, MD, CEO of the BioSpine Institute in Florida, told us that factors such as age, obesity, and medical history can increase the risk of all complications.
“The most common risk factors that can increase complications are age, weight, and other medical conditions like diabetes and heart condition, poor health, previous spine surgeries, bone disease such as ankylosing spondylitis, and prolonged steroid use.”
Improving safety during spinal surgery
Today, spinal surgeries are increasingly safe and are leading to improved patient outcomes. Multiple developments have driven these improvements. Dr. Beckett told us,
“Minimally invasive surgical (MIS) techniques have transformed the discipline by enabling us to achieve equivalent surgical results while minimizing trauma to nearby tissues. Consequently, this allows for smaller incisions, less blood loss, quicker recovery, and lower infection rates.Moreover, sophisticated imaging tools, such as intraoperative navigation and robotic-assisted surgery, have significantly improved our precision in hardware placement, thus reducing the potential for nerve damage or incorrect instrumentation. Innovations in biomaterials for spinal fusion, including biologics and new interbody devices, have enhanced fusion success rates and reduced hardware-related issues.”
Spinal surgery carries risks that can lead to poor patient outcomes. Improved technologies can help improve safety. Improved patient safety is a key factor in reducing the risk of errors and possible malpractice. Dr. Beckett said that patient communication also plays a key role.
“There are several best practices that I believe are crucial for achieving better patient outcomes in spinal surgery. Preoperative optimization is key. This includes managing conditions like diabetes, encouraging smoking cessation, optimizing body weight, nutrition, and participating in a pre-surgery physical therapy plan,” Dr. Beckett said. “Meticulous surgical technique and the use of advanced technologies also play a crucial role. Postoperative care is equally important, with early mobilization, proper pain management, and a focus on physical therapy to support the patient’s recovery. Lastly, thorough patient education about realistic outcomes, potential risks, and their role in recovery can help align expectations and contribute to a smoother postoperative course.”
What this means for you
“For a successful surgery, a thorough pre-surgery screening and educating the patient and managing expectations is needed,” Dr. Demian agreed. “Specifically crucial to make sure the patient achieves a full recovery is following with the patients post surgery, a thorough follow-up, a rehabilitation program before, which is as important as after the surgery.“