SETTLED Physiatrist Craig Anmuth, DO, was supposed to remotely monitor a woman's brain function during spinal surgery — but was allegedly driving in his car and making phone calls to a plumber and others instead.

A physiatrist who was supposed to be remotely monitoring a patient's brain function during her high-risk spine surgery was driving his car instead, according to a medical negligence lawsuit that was settled for $4.1 million this week.

Margaret Mary Niedzwiadek, a 59-year-old grandmother from Southampton, N.J., never woke up after the October 2013 surgery at AtlantiCare Regional Medical Center in Atlantic City, N.J., and was in a coma until she died nearly 2 months later of a catastrophic hypoxic brain injury, according to attorney Michael Trunk, who filed the suit on behalf of the patient's son, David Niedzwiadek.

Physiatrist Craig Anmuth, DO, was supposed to be monitoring Ms. Niedzwiadek's neuromonitoring signals remotely from a laptop in his office at the Bacharach Institute for Rehabilitation in Galloway Township, N.J. for the entirety of the surgery. Neuromonitoring is used to assess the functional integrity of the brain during high-risk procedures to alert the surgeons and anesthesiologists of irregularities.

Instead of monitoring Ms. Niedzwiadek's surgery from his office, Dr. Anmuth "was engaged in a number of unrelated activities, such as driving his car to the office, talking on his cell phone, and reviewing other patients' medical records," according to the complaint. Dr. Anmuth made or received 7 phone calls from his car, including one to "Tom the Plumber," as the surgery was taking place, court records show.

The suit alleged that the patient's signals diminished during the surgery, but that Michael Perro, the neuromonitoring technician in the operating room that Dr. Anmuth was tasked with overseeing, didn't notify surgeons of the changes. Mr. Trunk said the issues causing the signal changes, possibly the loss of blood flow because of how her neck was positioned, could have been remedied had the surgeons known about them.

The complaint alleges Dr. Anmuth lied about his location at the start of Ms. Niedzwiadek's surgery, the time he first attempted to log in to monitor the case — Dr. Anmuth didn't log on to the surgery until 50 minutes after it began, says Mr. Trunk — the unrelated activities he engaged in during her procedure and the status of his internet connection during the case. The suit also says that Dr. Anmuth and Bacharach installed anti-forensic software on the laptop that destroyed the evidence regarding Dr. Anmuth's computer activity during the surgery.

Ms. Trunk characterized the case as the most egregious case of malpractice he's seen in his nearly 20-year career.

"None of the healthcare providers would tell this poor family what really happened to their mother, and I'm grateful that our more-than-five-year investigation and prosecution of this case uncovered the truth and provided closure to the family," says Ms. Trunk. "The Niedzwiadeks want to make sure no other family has to endure the needless loss of a loved one, as happened here... Additionally, it's our hope that publication of the outcome here will serve to remind other neuromonitoring specialists of the importance of actually doing their job."

The settlement included a provision that prevents Dr. Anmuth from all neuromonitoring activity for one year, says Mr. Trunk. Dr. Anmuth still serves as the medical director at the Bacharach Institute, a spokesperson confirmed. The monetary portion of the settlement is $2 million from Dr. Anmuth, $1 million from Bacharach Institute for Rehabilitation, $1.1 million from Mr. Perro and Neuromonitoring Technologies, and $100,000 from AtlantiCare Regional Medical Center.

Mr. Perro's employer at the time of the surgery, Neuromonitoring Technologies in Glenwood, Md., did not respond to a request for comment. Dr. Anmuth and Mr. Perro could not immediately be reached. An AtlantiCare Regional Medical Center spokeswoman declined comment.

Adam Taylor