Case #1043: Epidural Abscess
In January, it is alleged that the Plaintiff experienced severe back pain which required transportation by ambulance to a local hospital. At that time, laboratory work confirmed an elevated white blood count with a left shift — indicating an infectious process. Thereafter, the Plaintiff requested a transfer to the Defendant Hospital, which was accomplished on February 1.
At that time, the Plaintiff came under the care of the Defendant Physician who ultimately discharged the Plaintiff on February 18, with a diagnosis of severe back pain most likely due to discitis. The Plaintiff was discharged on pain medications in addition to an antibiotic.
On March 17, the Plaintiff was seen at the Defendant Physician’s office. At that time, the Defendant confirmed that he did not identify the specific source of the pain from which the Plaintiff suffered during his prior hospitalization, but understood that a significant infectious process was probably responsible.
On Friday, March 24, the Plaintiff contacted the Defendant Physician’s complaining of the onset of severe pain in his neck. The Plaintiff indicated that the pain was so severe in this new area, that his pain medications were not making him comfortable. In response, the Defendant increased the Plaintiff’s pain medication and scheduled an appointment to see him the following Monday (March 27). However, the pain was so severe notwithstanding the medications, that the Plaintiff presented to the Defendant Hospital at approximately 7:25 p.m. on Sunday evening, March 26. At that time, he complained of excruciating neck pain for approximately three days with pain (and “electric shock” like feelings) radiating down into both arms upon examination. The Plaintiff was neurologically intact, was able to move all extremities, and was admitted to the Defendant Hospital for an assessment of the acute neck pain.
Approximately 5:00 a.m. on March 27, nurses had to contact a physician for an increase in the Plaintiff’s pain medications because of the severity and intensity of the neck pain. He continued to complain of electric shocks and tingling sensations in his upper arms and, by 1:00 p.m., he had electric shock feelings and tinglings in his arms and legs. When asked, he also indicated that his pain was 9 out of 10 — 10 being the most severe pain imaginable.
At approximately 1:00 p.m. on March 27, the Plaintiff was taken for an MRI of the neck. However, duly authorized agents and/or employees of the Defendant Hospital failed to complete the study because the Plaintiff was coughing and/or sneezing. These Defendants failed to repeat the study that day.
It is alleged that when the Plaintiff presented to the Defendant Hospital on March 26, he had clear onset of new and severe symptomatology in his neck which required immediate assessment and examination. It is further alleged that the Defendant knew that the Plaintiff had a severe infection, had previously suffered with significant back pain, had a prior diagnosis of spinal stenosis (a narrowing of the spinal canal) — all of which required an immediate MRI of the neck and spine. It is alleged that had these Defendants and each of them conformed with the applicable standards of care, an MRI would have been completed in a timely fashion, which would have demonstrated an obvious abscess in the cervical spine. The abscess would have been diagnosed and immediately removed surgically, coupled with appropriate antibiotic therapy. Had these Defendants and each of them conformed with the applicable standards of care, the MRI would have been completed, the obvious abscess diagnosed, surgery completed with the Plaintiff recovering and leaving the Defendant Hospital neurologically intact.
However, in direct violation of the standards of care, these Defendants and each of them failed to obtain the MRI of the cervical spine, failed to re-attempt the MRI in a timely fashion, and permitted the Plaintiff to progress with his signs and symptoms.
As the afternoon of March 27 continued, the Plaintiff’s signs and symptoms worsened. Not only did he suffer with electric shock feelings in his upper arms, but as indicated, began to feel that symptomatology in his legs as well. Thereafter, he not only had an elevated temperature, but was unable to void due to ongoing progression of signs and symptoms. Moreover, the Plaintiff continued to complain of the pain and the electric shocks, which had increased over the afternoon of March 27. It is alleged that the Defendant Physician was aware of all of the above findings, but did not complete the MRI or other study of the neck and cervical spine as required.
It is alleged that the second Defendant Physician saw the Plaintiff in conjunction with the first Defendant Physician and failed to conform with the applicable standards of care. Specifically, at approximately 8:00 p.m. on March 27, the second Defendant Physician saw the Plaintiff. The Plaintiff’s temperature was still elevated and he was complaining of severe pain, inability to void as well as sweating. Notwithstanding the progression of the Plaintiff’s signs and symptoms as well as his condition, the Defendants did nothing to intervene.
By 10:00 p.m., on March 27, the Plaintiff started to complain of an inability to move his arms and legs. Amazingly, however, the Plaintiff was not seen by the second Defendant Physician until the early morning hours of March 28 (and not at all by the first Defendant Physician). At that time, neurological examination revealed that the Plaintiff had lost his sensation to pin-prick from his toes to above his nipples, and that he had no sensation over his upper extremities. Additionally, the Defendant detected no reflexes. The second Defendant Physician finally attempted to obtain a stat myelogram or MRI at the Defendant Hospital only to learn that there was no technician available at that time to do the studies. As a result, the Defendant Physicians contacted another hospital and arranged for a transfer.
However, because of these Defendants’ ongoing negligence, the Plaintiff was not admitted to the second Hospital until 4:48 a.m. on March 28. Shortly thereafter, the MRI was completed, which revealed the presence of an epidural abscess in the cervical spine. Surgery was completed to remove the abscess. However, the intervention on the part of these physicians and surgeons proved too little and too late. Due to the ongoing negligence of these Defendants in their failure to conduct the required tests and studies to determine the etiology of the Plaintiff’s cervical pain, the abscess was left to persist, compress the spinal cord, and ultimately render the Plaintiff quadriplegic.