Houston Neurosurgeon facing assault charges over lidocaine injections

[Agast]

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A Houston neurosurgeon is facing charges for allegedly over-injecting his patient with lidocaine.

“
In 2022, court records state ElFallal was treating a patient whom he also worked with at HCA for back pain.

It's alleged he over-injected her with lidocaine, causing seizures.

"It is alleged the complainant was in ICU, and the complainant was also still allegedly suffering from pain and memory fog," a magistrate said in court.”

“"There are other complainants that were treated by this defendant where there are open investigations. We do anticipate other charges to be filed, including at least two complainants, who have passed away since receiving treatments from this defendant," a representative for the state said”

 

[Asclepius186]

Um what. Curious to hear more details. And what’s a surgeon doing messing around with injecting all that lidocaine when they could just be fusing people if they really wanted to make money…

 

[RoloTomassi]

Something must be fishy if it's criminal charges not just lawsuit

 

[paindoc007]

Uhhhh, dont practice in TX.

I get the criminal charges against Dr death, but is the precedent now in this state to go after you criminally for a medical complication or AE?

 

[SSdoc33]

ICU implies post surgical

 

[lobelsteve]

Uhhhh, dont practice in TX.

I get the criminal charges against Dr death, but is the precedent now in this state to go after you criminally for a medical complication or AE?

Nope, Texas is too soft on bad docs. This is an exceptional case.

 

[Agast]

Since the “assault” happened in 2022, I’m guessing the patient first tried a lawsuit and no one would take her case, then tried the Texas medical board and was told the consent for injections includes risk of seizures. Filing assault charges is their last attempt to punish the doctor and it stuck.

 

[BobBarker]

Could have been a nursing error. 2% instead of 1% on a small patient.

 

[Agast]

I don’t think it was from the subcutaneous injection for numbing the site though - I wonder if he uses lidocaine in his epidural mixture and this was a cervical spine procedure. Saline only for me.

 

[PMROralBoards]

Could have been a nursing error. 2% instead of 1% on a small patient.

Always draw up my own meds. I once had a nurse hand me toradol instead of saline while getting prepped for a cervical epidural.

I don’t think it was from the subcutaneous injection for numbing the site though - I wonder if he uses lidocaine in his epidural mixture and this was a cervical spine procedure. Saline only for me.

I also only do saline with dex for cesi. The benefit and risk profile for using lidocaine just doesn’t make sense to me.

 

[MitchLevi]

So many details I'm not seeing on that link. I watched the video.

A patient was in the ICU and had back and leg pain, with "memory fog."

Why in the ICU? Was it post op?

Literally no information at all, but there are two others who have died apparently?

The TMB reviewed the case and took no action.

There is no information. Was he running IV lidocaine?

 

[Agast]

Always draw up my own meds. I once had a nurse hand me toradol instead of saline while getting prepped for a cervical epidural.

I got 0.25% bupivicaine labeled as contrast for a cervical ESI. She grabbed the wrong vial. Luckily I was still in the muscle and figured it out pretty quickly but I still have a grudge against this particular tech.

 

[Taus]

I got 0.25% bupivicaine labeled as contrast for a cervical ESI. She grabbed the wrong vial. Luckily I was still in the muscle and figured it out pretty quickly but I still have a grudge against this particular tech.

Yep. I draw up all my own medications majority of the time… But when I have two rooms in Asc, or a fellow in office….. They can draw up my local and contrast only. Injectate gets drawn by me. And I take a spot shot on the field with the contrast syringe to confirm its contrast before I inject. Trust but verify.

 

[Status Sciaticus]

Yep. I draw up all my own medications majority of the time… But when I have two rooms in Asc, or a fellow in office….. They can draw up my local and contrast only. Injectate gets drawn by me. And I take a spot shot on the field with the contrast syringe to confirm its contrast before I inject. Trust but verify.

This is the way.
Cant trust anyone but yourself for the most important part.
I draw up the local, contrast, and injectate. It doesnt add too much to my time. maybe 30 seconds for peace of mind.

 

[Dansk2011]

I saw a lady the other day who had neuropathic pain after a hemorrhagic stroke induced by an anesthesiologist accidently injecting Tranexamic acid during a spinal block. Don't know the full story but the meds were drawn up before the surgical case by a nurse and clearly not labeled. He grabbed a syringe with clear fluid in it and injected.

 

[MitchLevi]

I saw a lady the other day who had neuropathic pain after a hemorrhagic stroke induced by an anesthesiologist accidently injecting Tranexamic acid during a spinal block. Don't know the full story but the meds were drawn up before the surgical case by a nurse and clearly not labeled. He grabbed a syringe with clear fluid in it and injected.

Dang.

Institutional risk involved when you push responsibility further and further down the chain of command in the interests of efficiency and maximal billing.

I’m sure they sued everyone and they found a way to nail the doctor too.

 

[Agast]

I saw a lady the other day who had neuropathic pain after a hemorrhagic stroke induced by an anesthesiologist accidently injecting Tranexamic acid during a spinal block. Don't know the full story but the meds were drawn up before the surgical case by a nurse and clearly not labeled. He grabbed a syringe with clear fluid in it and injected.

Was this in California? I think they suspended his license or something and someone posted it here

 

[Dansk2011]

Was this in California? I think they suspended his license or something and someone posted it here

Colorado

 

[Ducttape]

i cant find any more info other than he used 1% lido for the local anesthetic and then may have injected 4% in to the epidural space.


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[MitchLevi]

i cant find any more info other than he used 1% lido for the local anesthetic and then may have injected 4% in to the epidural space.


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Ha!!! What? Anyone here super confident in their interlaminar skills? Wanna try 4% lido in the neck?

 

[pmrmd]

I saw a lady the other day who had neuropathic pain after a hemorrhagic stroke induced by an anesthesiologist accidently injecting Tranexamic acid during a spinal block. Don't know the full story but the meds were drawn up before the surgical case by a nurse and clearly not labeled. He grabbed a syringe with clear fluid in it and injected.

A hemorrhagic stroke after pushing an agent that reduces bleeding and they blamed him?

 

[Dansk2011]

A hemorrhagic stroke after pushing an agent that reduces bleeding and they blamed him?

Whatever happened to her apparently happened almost immediately after he administer the injection because she was transferred to our hospital from the OR (was done at OSH). I think her BP shot up really high really quickly then she suffered the stroke. So either it was a freak coincidence or it was a direct cause.

 

[MitchLevi]

Whatever happened to her apparently happened almost immediately after he administer the injection because she was transferred to our hospital from the OR (was done at OSH). I think her BP shot up really high really quickly then she suffered the stroke. So either it was a freak coincidence or it was a direct cause.

It was ischemic with hemorrhagic conversion? I’d think that would be the more likely scenario.

 

[Agast]

A hemorrhagic stroke after pushing an agent that reduces bleeding and they blamed him?

It turns out he took her to an OON facility

She took one look at her bill and stroked out

 

[jsaul]

This surgeon has been doing ESIs, RFAs and SCS for the past 5 years since coming from Michigan. I have heard stories from the OR techs and nurses and xray techs of him leaving sponges in the body, malpositioned hardware etc

The thing was he thought he was so great at doing pain procedures and essentially pain docs are not needed

 

[bedrock]

This surgeon has been doing ESIs, RFAs and SCS for the past 5 years since coming from Michigan. I have heard stories from the OR techs and nurses and xray techs of him leaving sponges in the body, malpositioned hardware etc

The thing was he though so great and pain procedures and essentially pain docs are not needed

Sounds like dr death 2.0.

 

[Agast]

I’m torn on whether a bad injection constitutes assault, but using 4% lidocaine is pretty stupid. Is it illegal to be stupid?

 

[lobelsteve]

I’m torn on whether a bad injection constitutes assault, but using 4% lidocaine is pretty stupid. Is it illegal to be stupid?

Holding a needle in a closed fist and repeated rapid trigger points?

 

[Dansk2011]

It was ischemic with hemorrhagic conversion? I’d think that would be the more likely scenario.

Her BP went wildly high which they believe was the source of the hemorrhage. She fortunately doesn't have anything major residual outside of neuropathic pain.

 

[mdo1738]

I’m torn on whether a bad injection constitutes assault, but using 4% lidocaine is pretty stupid. Is it illegal to be stupid?

97% of the country would be in jail if that was illegal.

 

[clubdeac]

Dang.

Institutional risk involved when you push responsibility further and further down the chain of command in the interests of efficiency and maximal billing.

I’m sure they sued everyone and they found a way to nail the doctor too.

They call it “practicing at the top of their license” biggest bs term ever

 

[buddababa]

They call it “practicing at the top of their license” biggest bs term ever

i hate the that term so much

 

[au bon pain]

I used to work at a place that started to embrace this “top of the license” nonsense—and then quietly tried to get us to sign off on midlevel charts for patients we had no connection with for $admin$trative$” purposes. I said no. They gave me an ultimatum of accepting a hefty raise and signing the charts or leaving. So I left. Best decision ever and that group lost so many docs they could no longer function.

 

[Dansk2011]

I used to work at a place that started to embrace this “top of the license” nonsense—and then quietly tried to get us to sign off on midlevel charts for patients we had no connection with for $admin$trative$” purposes. I said no. They gave me an ultimatum of accepting a hefty raise and signing the charts or leaving. So I left. Best decision ever and that group lost so many docs they could no longer function.

I had a similar experience with my first job out of fellowship. Wasn't just mid-levels though. They wanted me to do if for mental health therapists (they had an addiction side of the practice which probably should have been a red flag...). Said no and I left not too long after starting. They ran through docs until they ultimately shut down.