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Villa v. The City of Long Beach

Dr. Robert Klapper Outlines Crash Victim’s Injuries in Trial Against California City

The Expert: Dr. Robert Klapper, an orthopedic surgeon from California, outlines the spinal injuries the plaintiff sustained.

By Dr. Gary F. Gansar, MD, FACS
Senior Physician Medical Director, AMFS

Dr. Robert Klapper, an orthopedic surgeon from West Hollywood, California, testifies during a 2019 California trial. The plaintiff in this trial claimed that unsafe road conditions caused a crash that catastrophically injured him. The orthopedic expert elaborates on the spinal injuries that the plaintiff sustained.

Klapper first addresses the neck surgery that was done on the plaintiff using an animation that allows the jury to simply see what injuries were repaired and how. The expert communicates easily with the entire courtroom, and describes how the surgeon, using pedicle screws and parallel rods, attempts to stabilize the multiple fractures before permanent and severe damage to the spinal cord results. The operation results in the fusion of the C4 through T1 vertebra, which will allow the fractures to heal and keep the comminuted pieces from wreaking havoc on nerve structures within and coming from the spinal cord. He explains, “You are making all of those separate bones into a single bone and that stabilizes the spine.”

As an aside, the expert describes that, despite the proper closure of the wound in this operation, the patient developed a keloid scar on the back of his neck. This is essentially an overhealing of the sutured skin that results in a thickened, raised, painful, or itching scar “from top to bottom,” or throughout its entire length. There is nothing that we know of that could be done to prevent this from happening as there is a genetic predisposition in some patients to develop this problem with scars.

The doctor then displays X-rays taken in his office that demonstrate that the curvature of the spine after this accident could not be exactly reconstructed by the surgery. This abnormal alignment will permanently cause the plaintiff to have significant discomfort. The hardware should remain in the patient forever, unless it becomes infected or breaks. Reoperations would be very dangerous, he says, as normal landmarks are obliterated and scarring puts nerve and vascular structures at risk for injury.

After establishing his expertise in reading MRIs of the neck, Klapper takes the jury through an examination of the non-bony soft tissues of the spine as seen on those films. The fractured areas resulted in bleeding deep into the spine and the scarring has encroached upon nerve structures. This caused the nerve damage that had been documented by other experts in this case.

The expert provided clear testimony on plaintiff’s neck injury and its  relationship to his disability and pain, though the jury ultimately decided the city was not liable for the injury.

About the Author Dr. Gary F. Gansar, MD, FACS

Gary Gansar, MD, is residency-trained in general surgery. He served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Touro Infirmary and Mercy Hospital in New Orleans, LA. Dr. Gansar was Board Certified in general surgery while in active practice. He joined AMFS in 2015 as a Physician Medical Director.

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