NERVE BLOCK INJECTIONS: HOW, WHY & CONCERNS

A “nerve block” is essentially what the name implies.  It is a pain management tool used by physicians and other health care providers to block a nerve and thus to block pain, either during or immediately after a surgery.  Less commonly, nerve blocks can serve as a diagnostic tool and may be used to figure out the root cause of a patient’s pain or to test a patient’s response to such an injection before proceeding with other long-term treatments.

HOW

Nerve blocks are usually accomplished through relatively simple injections performed on areas of the body wherein nerves bunch together before emanating through a part of the body, such as down a limb or through the back.

WHY

These procedures have become critical in the field of interventional pain management and are often used by physicians specializing in the treatment of chronic pain. The Louisiana State Board of Medical Examiners (LSBME) has advised that when used for the purposes of interventional pain management, it is not the procedures—but the purpose and manner in which such procedures are utilized—that demand the ongoing application of direct and immediate medical judgment, which constitutes the practice of medicine, and which may only be performed in this state by a Louisiana licensed physician.  This means that in such instances, nerve blocks (and similar procedures) are not delegable to a non-physician, such as a CRNA.

CONCERNS

Nerve blocks, however, are not without risk and can cause substantial harm to the patient if performed incorrectly.  This is because the procedure involves inserting and guiding a sharp needle proximate to the nerve bundle and injecting powerful pain blocking drugs to temporarily stop the nerves from communicating pain to the brain.  The risks associated with such a procedure are inherent due to the fragile nature of the body’s nervous system.  This is even more true because the most common areas of the body for nerve blocks are at the base of the neck (cervical spine) and the lower back (lumbar spine).  Further still, some patients are simply difficult to anesthetize, making procedures such as nerve blocks particularly challenging.

As such, a poorly performed nerve block can cause highly painful, intense, and often permanent injury.  Due to these and other risks, many physicians disfavor and even shy away from performing nerve block injections and will instead rely on other pain management resources to optimize patient care.  Further still, the LSBME does not support the practice of physicians prescribing and administering nerve block injections based on a single in-office visit.  There must generally be evidence of some further evaluation or diagnostic testing of the patient’s complaints prior to receiving a nerve block injection.  The Board also recommends that physicians try out less invasive therapies before resorting to a nerve block.

When it comes to performing nerve block injections, it is equally important that the treating physician obtain the patient’s complete medical history and workup prior to treatment, and that the patient be fully informed of all material risks associated with the treatment before giving consent.

CONTACT US

For more information on nerve block injuries and potential liability, please contact our office.  We would be happy to help!

Estate Planning (Generally)

Start by making a Last Will and Testament (or a “Will”).  You can schedule an appointment with a licensed attorney who handles estate planning and probate work, or you may even write one yourself.  While handwritten (or “olographic”) testaments can be upheld, certain form requirements must be met, and the process for administering a handwritten Will is often more difficult and costly.

Of course, you may choose instead to seek legal counsel to prepare what is called a “notarial testament” in order to avoid the many issues which can arise with handwritten Wills.  A lawyer will prepare your Will in writing in accordance with your wishes, which will be dated and signed by you and a notary in the presence of two witnesses.  The length, content, and complexities of your testament will vary greatly depending on your estate and any specific wishes that you may have.

Be mindful that there are special provisions in place for the signing of Wills by persons who are unable to read or write.  If someone you know is interested in preparing a Last Will and Testament but has not already done so due to a disability, encourage him or her to contact an attorney for assistance.

Living Will

Louisiana Supreme Court allows co-defendant to appeal granting of Motion for Summary Judgment

The Louisiana Supreme Court resolved a split in the State Court of Appeals in its opinion in “Stephen Amedee & Tanya Amedee vs. Ambridge Hospitality LLC d/b/a Embassy Suites New Orleans et al” (attached) concerning whether where there are multiple defendants in a lawsuit and where one defendant is dismissed on summary judgment, can a co-defendant appeal that dismissal where the plaintiff does not appeal the dismissal. The Louisiana Supreme Court held that a defendant may appeal the summary judgment dismissal of a co-defendant even when the plaintiff chose not to appeal. The reasoning is based upon the pleading of comparative fault and La. C.C.P. art. 966’s mandate that no evidence can be introduced at trial of the fault of a party dismissed on summary judgment.