A seemingly routine surgery in Suwon, South Korea, took a devastating turn, leaving a man paralyzed from the neck down—a stark illustration of the uphill battle patients face when challenging medical institutions.
The Fight for Accountability in Medical Disputes
Table of Contents
Every year, thousands of medical disputes in Korea unfold, often resembling a David-and-Goliath struggle for patients and their families.
- Medical disputes in Korea are frequently resolved through mediation, arbitration, or civil lawsuits.
- Proving medical negligence can be incredibly difficult due to “information asymmetry” – a gap in knowledge between patients and medical professionals.
- A recent case highlights the challenges of navigating the legal system, even with support from the National Pension Service.
- Legal experts suggest focusing claims on the most demonstrable instances of negligence to improve chances of success.
Mr. B, diagnosed with posterior longitudinal ligament ossification and spinal cord disease at Hospital A, underwent decompression surgery to alleviate nerve compression. Prior to the procedure, he experienced abnormal sensations in both arms. But just four and a half hours later, those sensations—and much more—were gone. A post-operative examination revealed a complete loss of motor function in his hands, shoulders, knees, and feet. Hospital A immediately administered dexamethasone, a steroid, and performed a cervical spine MRI, revealing cervical spinal edema and a suspected spinal cord infarction in the anterior vertebral artery region—essentially, a stroke within the spinal cord.
Despite an urgent transfer to a higher-level hospital, Mr. B was diagnosed with permanent quadriplegia. The case quickly escalated, becoming a complex legal battle. The National Pension Service, having paid approximately 57.6 million won (roughly $43,000 USD) in disability benefits to Mr. B over nearly three years, joined the lawsuit against Hospital A as a ‘plaintiff successor.’
Court Dismisses Claims Despite National Pension Service Support
The plaintiffs alleged multiple instances of negligence: ① failure to adequately address low blood pressure during surgery; ② inadequate monitoring for nerve damage; ③ damage to the spinal cord caused by surgical equipment; ④ delayed diagnosis of the spinal cord infarction and insufficient follow-up care; ⑤ inadequate infection control and aseptic techniques; and ⑥ insufficient guidance regarding potential complications and post-operative care. However, the 14th Civil Division of Suwon District Court (Judge Moon Hyeon-ho) ultimately dismissed all claims.
The court’s decision heavily relied on the findings of the Korea Medical Dispute Mediation and Arbitration Board. The court found that vasopressor medication effectively restored Mr. B’s blood pressure after a dip during surgery, and there was no evidence to suggest that standard imaging tests weren’t performed. Crucially, the Arbitration Board concluded that “the surgery is presumed to have been carried out without any abnormalities.”
Regarding the alleged spinal cord injury from surgical instruments, the court ruled that other causes couldn’t be ruled out, and proving negligence in that regard based on the available evidence was “difficult.” The Arbitration Center also suggested that the observed edema could be a result of “physiological changes” as pressure on the compressed spinal nerves was released. This concept, known as reperfusion damage—cell damage occurring when blood flow is restored after a blockage—is generally not considered negligence on the part of medical staff.
The court also determined that there was no undue delay in diagnosis or treatment, considering the time required for post-operative recovery, symptom assessment, medication administration, and MRI scans. Furthermore, there were no signs of infection, such as elevated inflammatory markers or fever.
Attorney Highlights Pitfalls of Overly Broad Claims
Attorney Cho Jin-seok, of Oh Kims Law Firm, believes the plaintiffs’ broad range of claims contributed to their defeat. He argues that presenting too many arguments can dilute the persuasive power of the case and create a negative impression on the court. He emphasized that Mr. B’s limited time to consider the surgery—receiving risk explanations and consent forms only the day before the procedure—could have been a stronger focus, potentially highlighting an infringement on his “right to self-determination” or “right to choose.”
“Alleging multiple faults focuses on the main issues and prevents an efficient hearing,” Cho said. “This can also create a bad impression on the court. It would have been desirable to focus the claim only on points of negligence that are highly likely to be recognized in order to be recognized as liable for damages.”
Cho also pointed out the limitations of relying solely on medical evaluations from arbitration centers, as these evaluations are ultimately based on the expertise of doctors. He suggested that having medical professionals directly involved in the trial process—those capable of thoroughly reviewing medical records—is advantageous.
“According to legal principles, an appraisal regarding medical negligence must be obtained from a person in the same profession,” Cho explained. “It is inevitable to request an appraisal from the Korea Medical Dispute Mediation and Arbitration Board, the Korean Medical Association, the Korean Dental Association, and the Korean Oriental Medicine Association.” He added, “If you know well about medical care, you can write appraisal questions that fit the issue, such as proving negligence and acknowledging causality, when writing the request for appraisal request.” He concluded, “In order to win the case, it is advisable to appoint a lawyer with a lot of experience in medical cases, such as a medical lawyer or a lawyer with a medical license.”
