Mr. B and a physician struggled to get the bleeding under control by applying more pressure to the wound. After the patient was stabilized, Mr. B prepared to suture. Mr. R had cut an artery, and the deep laceration would require a lot of work.

Mr. R began cursing again as Mr. B began sewing.

“Damn it! That hurts,” he yelled. “What the hell are you doing!? Get off of me!”

Mr. B calmly explained that he was suturing Mr. R’s arm so he wouldn’t bleed to death. Although the patient’s attitude rattled him a bit, the PA kept stitching.

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“Ow!” screamed Mr. R. “It feels like my arm was just zapped—like you did something to my funny bone!”

“Don’t worry,” said Mr. B. “You’ll be fine. This is normal.”

He finished treating the wound, made a note in the chart about the number of stitches, and left the room hoping never to see Mr. R again. That wish did not come true. Three days later the young man reappeared, complaining of numbness and pain in his fourth and fifth fingers.

“What did you do to me?” he demanded. “Something is wrong with my hand.”

Mr. B examined the wound and the hand and told the patient the discomfort was a normal part of the healing process.

Dissatisfied with that answer, Mr. R consulted a hand surgeon after the pain and numbness deteriorated into paralysis of his fourth and fifth fingers. The surgeon diagnosed significant damage to the ulnar nerve and recommended exploratory surgery to determine the underlying cause.

After the operation, the surgeon outlined the probable scenario. “A suture used to tie off bleeding vessels  somehow tied off your ulnar nerve,” he explained to Mr. R. “As a result, your ulnar nerve was deprived of oxygen and blood flow, causing the nerve to die.”

He went on to say that Mr. R would need another surgery to try to repair the nerve or to transplant another nerve from a different part of his body. “While nerves can regenerate,” he warned, “they do so at the rate of about an inch per month, so it’s a slow process.”

During the second surgery, the surgeon cleaned and stretched the existing nerve and reattached the damaged ends. However, even 18 months after the re-attachment procedure, Mr. R was still coping with a loss of sensation and diminished function in his hand.

He decided to hire a plaintiff’s attorney to explore the idea of suing the hospital and Mr. B for negligence. The lawyer contacted the hand surgeon and asked, “If my client’s nerve damage had been recognized when he first returned to the hospital complaining of pain and numbness, would this injury have been reversible?”

“Absolutely,” said the physician. “It would have been much easier to treat closer to the time it happened. Basically, his ulnar nerve was dying right before the eyes of the hospital staff.”