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AANS Neurosurgeon | Volume 28, Number 1, 2019


Notice of Disciplinary Action

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The following disciplinary actions have been taken against members of the American Association of Neurological Surgeons (AANS) for unprofessional conduct while serving as an expert witness in medical malpractice lawsuits.

  • Six (6) Month Suspension – In an appeal by Nancy Epstein, MD, FAANS, FACS, of Mineola, New York, the general membership voted to sustain a decision by the Board of Directors to suspend her membership for six (6) months. The Board concluded that Dr. Epstein violated Sections A.3 and A.4 of the AANS Rules for Neurosurgical Medical/Legal Expert Opinion Services by testifying in a discovery deposition and at trial that the performance of a TLIF procedure was below the standard of care for the treatment of lumbar stenosis with spondylolistheses, although Dr. Epstein acknowledged that many neurosurgeons perform the procedure and disagree with her view. Dr. Epstein also testified that the occurrence of a nerve root injury during the surgery constituted a per se violation of the standard of care.
  • Censure – The Board censured W. Lynn Stringer, MD, FAANS, of Flowood, Mississippi for opinions expressed in expert witness affidavits concerning the interval of time between an MRI showing a thoracic epidural abscess and surgery. Dr. Stringer opined that a failure to perform immediate surgery or transfer the patient to another facility resulted in a worsened neurological outcome and breached the standard of care. The Board found such testimony violated Sections A.1 through A.4 of the AANS Rules for Neurosurgical Medical/Legal Expert Opinion Services because Dr. Stringer did not cite scientific or clinical evidence, failed to be non-partisan, and neglected to identify personal opinions as such or acknowledge the full standard of care. Dr. Stringer did not pursue an appeal to the general membership.
  • Censure – The Board censured Carlos Bagley, MD, FAANS, of Dallas, Texas for certain deposition and trial testimony in a case where the surgeon performed an anterior discectomy and fusion at the proper level, but preoperatively mislabeled the vertebral level numbering. The Board found that Dr. Bagley used the miscounting as justification to testify that the surgeon violated the standard of care by operating at the wrong level even though the correct clinical level was surgically decompressed based on MRI findings. The Board did not find any indication of foraminal stenosis to support a wrong level surgery and, therefore, concluded that Dr. Bagley’s testimony was not impartial and constituted violation of Sections A.1 through A.5 of the AANS Rules for Neurosurgical Medical/Legal Expert Opinion Services. Dr. Bagley did not pursue an appeal to the general membership.


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Fred Brown | June 19, 2019 at 10:32 am

I find the second case of an epidural abscess a bit troubling. If the patient with an epidural abscess deteriorated neurologically and surgery was delayed, aren’t we setting a low standard by not treating this as an emergency?