Cauda Equina Syndrome Verdict: $4 Million
2014 Medical Malpractice Trial Report
By William J. Thompson
Medical Malpractice Attorney
Lawsuit claims herniated disc leads to permanent neurologic injuries due to cauda equina syndrome
The plaintiff is a 46-year-old woman who has permanent neurologic injuries requiring her to self-catheterize to pass urine and manually dis-impact her stool. In addition, she has loss of sensation in her buttocks and pelvic area, including loss of sexual sensation.
When she was 38 and working as a machine operator in a plastics factory, she hurt her back. She saw her doctor, was given pain medication and muscle relaxants, and continued working. About a month later, she reinjured her back and went to the Emergency Department (ED) of her local community hospital. The ED doctor discharged her with a back sprain and told her to follow up with her primary care physician (PCP). She did not see her PCP, but instead returned five days later to the same ED, now complaining of numbness in her buttocks going down her legs. She was given pain medication and scheduled for an MRI in a few days. She was unable to lie still for that MRI so it was rescheduled three days later. Again, she could not lie still due to the pain. She returned to the ED four days later with back pain and numbness. In the ED, she had a small amount of urinary leakage and urinary retention. The ED doctor had some concern for cauda equina syndrome (CES), a condition arising from compression of the nerves in the low back, and admitted her. It was a Friday night.
See other recent failure to diagnose cauda equina medical malpractice cases:
- $2 million settlement: Delay in diagnosis of cauda equina results in chronic urinary retention and weakness
- $1 Million Settlement: Hospitalist and neurosurgeon fail to diagnose cauda equina
- $1 Million Settlement: Delay of spinal surgery causes permanent neurological injuries
- $1 Million Settlement: Back pain, radiating to legs attributed to diabetes, not cauda equina
On Saturday morning, the attending doctor was also concerned about the possibility of CES. He ordered an MRI and a consult with a spine surgeon. The spine surgeon saw the patient and was less concerned about CES, pending the results of the MRI. The MRI was done around midday Saturday, but there was no radiologist available at the hospital to read it over the weekend. The spine surgeon read the MRI on Sunday, recognized a disc herniation, and scheduled surgery for the next day. On Monday, he performed a successful discectomy, however due to the period of time that the nerves were compressed, the patient did not recover normal neurologic function or sensation.
The plaintiff claimed that CES is a surgical emergency, and that the surgeon delayed in surgically decompressing the nerves. The plaintiff contended there should have been better communication between the attending and surgeon, a more prompt reading of the MRI, and earlier surgery or transfer to another facility for higher level care.
The defendants contended that the symptoms did not clearly indicate CES, an extremely rare condition, and therefore they did not breach any standard of care. Moreover, the symptoms were improving or absent over the weekend. The defendants further contended that even if it should have been diagnosed as CES, the patient was taken to surgery within the appropriate and recognized window to perform surgery.
The case was tried over nine days. The jury deliberated for a day and half. The jury awarded $2,340,000 for general damages, and $825,000 for lost earning capacity. There were no offers. With interest, the total judgment is approximately $4,000,000.
Lubin & Meyer attorney William J. Thompson representd the plaintiff in this lawsuit.
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