Shoulder Viscus Injury: What I Look for When a Shoulder Case Isn’t Really About the Shoulder
When internal structures are injured during shoulder care, patients deserve real answers—not reassurances, not excuses, and not silence. They deserve accountability.
I’ve handled enough medical malpractice cases to know that when something goes wrong in the shoulder, it’s often not just an orthopedic problem.
The shoulder sits in one of the most anatomically crowded areas of the body. When a doctor treats it casually, the consequences can be serious.
That’s where shoulder viscus injuries come in. They don’t always announce themselves loudly. In fact, they’re often missed precisely because they don’t look dramatic at first.
A patient comes in for what’s supposed to be a routine shoulder procedure. An injection. Arthroscopic surgery. A nerve block. Maybe fracture care after a fall. What follows is pain that doesn’t make sense, shortness of breath that gets brushed off, numbness or weakness that’s chalked up to normal recovery.
It isn’t normal. And it isn’t acceptable.
What Doctors Mean—and What Patients Experience
In medicine, the term “viscus” refers to internal organs or vital internal structures. Around the shoulder, that includes things most patients are never warned about: the top of the lung, major blood vessels, and critical nerve bundles that control the arm and hand.
When those structures are injured during medical care, the damage can be profound. I’ve seen cases involving punctured lungs, uncontrolled internal bleeding, permanent nerve damage, and loss ofarm function. These are not rare Wukes. They are known risks in a known danger zone.
The troubling part is how often these injuries are missed or minimized early on.
How These Injuries Actually Happen
Most shoulder viscus injuries don’t come from reckless behavior. They come from complacency.
A needle placed a little too deep. An instrument advanced without proper visualization. A nerve block performed without adequate imaging or experience. Poor patient positioning. Failure to account for anatomy that doesn’t fit the textbook perfectly.
Doctors are trained to know this area is tight and unforgiving. When something goes wrong, it’s often because safety protocols were rushed or ignored, not because the risk was unavoidable.
When I review these cases, I’m not asking whether the provider tried their best. I’m asking whether they respected the anatomy and followed the standard of care.
The Damage Isn’t Always Immediate
One of the hardest things for patients is that the injury doesn’t always declare itself right away.
A lung injury may start as vague chest discomfort. A vascular injury might present as swelling orunexplained pain. Nerve damage can show up as tingling, weakness, or loss of coordination that gets dismissed as temporary.
Meanwhile, the clock is ticking. Delayed diagnosis often turns a treatable injury into a permanent one. From a legal standpoint, that delay matters just as much as the initial mistake.
Where Negligence Shows Up
Not every bad outcome is malpractice. But shoulder viscus injuries often raise serious concerns because the warning signs are there—if anyone bothers to look.
Failure to properly image before or during a procedure. Failure to listen when a patient reports symptoms that don’t match routine recovery. Failure to investigate complications promptly. Failure to document what actually happened.
I’ve seen records where complications are glossed over or vaguely described. That’s not an accident. That’s what happens when providers realize something went wrong and don’t want to confront it.
Why These Cases Are Missed—and Why They Shouldn’t Be
These injuries often fall into a gray area between specialties. Orthopedics looks at the joint.
Pulmonology looks at the lung. Neurology looks atthe nerves. No one steps back and asks whether the injury was caused during care.
By the time the full picture emerges, the patient has been living with pain or disability for months. Sometimes years.
The law doesn’t excuse that delay simply because the injury was inconvenient to diagnose.
The Bottom Line
The shoulder is not a simple joint. Treating it like one is a mistake.
When internal structures are injured during shoulder care, patients deserve real answers—not reassurances, not excuses, and not silence. They deserve accountability.
In my experience, shoulder viscus injuries are often preventable. And when they are, the responsibility lies squarely with the providers who failed to respect the risks they were trained to understand.
Frank Gaudio is a partner at Miller & Gaudio, P.C., based in Red Bank. He has tried and resolved complex personal-injury and medical-malpractice cases for more than three decades and writes frequently about the intersection of law, technology, and patient safety.
Page printed from: https://www.law.com/njlawjournal/2026/02/20/shoulder-viscusinjury-what-i-look-for-when-a-shoulder-case-isnt-really-about-theshoulder/print/
NOT FOR REPRINT © 2026 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to asset-and-logo-licensing@alm.com. For more information visit Asset & Logo Licensing.
