Citation Nr: 21069138 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 18-23 118A DATE: November 17, 2021 REMANDED Entitlement to compensation under 38 U.S.C. § 1151 for brachial plexopathy, also claimed as unstable left side, resulting from cardiac surgery performed at the Portland VA Medical Center (VAMC) in October 2014 is remanded. INTRODUCTION The Veteran served on active duty in the United States Navy from July 1963 to June 1967. This case comes before the Board of Veterans' Appeals (Board) on appeal of a June 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). REASONS FOR REMAND Initially, the Board notes the Veteran's above-noted claim for compensation pursuant to 38 U.S.C. § 1151 stems from surgical treatment received at the Portland VAMC in October 2014. The Veteran claims a mistake or error occurred during his procedure and caused his current nerve damage. Following his October 2014 cardiac surgery, the Veteran complained of upper extremity numbness in the ulnar distribution on his left side. At his follow-up appointments, he continued to report symptoms of extreme left arm pain and numbness. He was referred to neurology in April 2015. Prior to his neurology consult, he had an EMG in January 2015 and was diagnosed with brachial plexopathy, lesion of median nerve, and bilateral ulnar neuropathy. Additionally, the Veteran received a safety notification in December 2016 regarding the equipment used during his cardiac surgery. He called the VA and reported his post-surgical symptoms. Based on the safety notification he received, he questioned whether a potential infection could have caused his post-surgical symptoms, to include left-sided weakness and numbness. The Veteran has not been afforded a VA examination to address his claim for compensation under section 1151. As noted above, the Veteran has a current disability of brachial plexopathy. The medical evidence shows the symptoms related to his current disability started following his October 2014 cardiac surgery. The Board finds a VA examination and medical opinion is necessary to determine whether the Veteran's brachial plexopathy was proximately caused by his October 2014 cardiac surgery. Accordingly, this case is REMANDED for the following action: Afford the Veteran a VA examination by an examiner with sufficient expertise and experience, who is not employed at the Portland VAMC, to fully assess the etiology of the Veteran's brachial plexopathy. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Based on a review of the Veteran's pertinent history and the examination results, the examiner should state an opinion as to whether it was at least as likely as not (a 50 percent or greater probability) that the Veteran's brachial plexopathy resulted from his October 2014 cardiac surgery at the Portland VAMC. In this respect, the central issue that must be determined by the examiner is whether the Veteran's brachial plexopathy was at least as likely as not (a 50 percent probability or greater) proximately caused or aggravated by: a) carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the Portland VAMC; or b) an event that could not have reasonably been foreseen by a reasonable healthcare provider administering the Veteran's October 2014 cardiac surgery. In this regard, the examiner must discuss and consider the Veteran's reported symptoms, as well as the December 2016 heater cooler national safety notice and any possible subsequent infection. The examiner must provide a complete rationale for any opinion expressed. If the examiner is unable to provide the required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nestander, Jessica S. The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.