At its meeting on April 24, 2025, the Board of Directors of the American Association of Neurological Surgeons approved the recommendation of the Professional Conduct Committee to discipline a member for unprofessional conduct while serving as an expert witness in a medical malpractice lawsuit. The disciplinary action is as follows:
John H. Chi, MD, FAANS – Censure. The Board concluded that Dr. Chi violated Section A.2 of the AANS Rules for Neurosurgical Medical/Legal Expert Opinion Services concerning impartial testimony and giving different viewpoints regarding the practice behavior of a prudent neurological surgeon if such there are. In the underlying case, a patient was seen in an office visit for neck and bilateral arm pain that radiated down the back of her arm to her hand. Imaging studies revealed degenerative changes from C4 to C7, with the worst changes at C6-7. After epidural steroid injections at C6-7 offered significant but temporary relief, the patient subsequently elected surgical intervention. The neurosurgeon fused only the two lower levels primarily because C4-5 did not seem to be a cause of her arm pain. Surgery relieved the patient’s symptoms for several months, but then her symptoms recurred in an inconsistent pattern and with occasional pain-free intervals. A cervical myelogram/CT scan seven months post-op showed good bony fusion at C5-6 and C6-7. The neurosurgeon recommended waiting before considering an ACDF at C4-5. The patient instead went elsewhere for a C4-5 ACDF. Her symptoms did not improve, and she subsequently underwent several additional cervical spine surgeries by various surgeons. The Board determined that Dr. Chi violated Rule A.2 when he stated in an affidavit of merit that the neurosurgeon breached the standard of care in performing surgical intervention only at C5-6 and C6-7 but not also at C4-5. The Board found that this expert opinion did not represent the practice behavior of a prudent neurological surgeon or adequately represent different viewpoints in the initial surgical management of this patient, including performing no surgery at all or fusing one, two or three levels, given the patient’s symptoms. The Board did not find Dr. Chi in violation of Sections B.2 or B.3, which relate to reviewing all pertinent available medical information about the patient and familiarity with standard neurosurgical practices.
