Epidural Abscess Resulting in Paralysis: $2.75M Settlement
2015 Medical Malpractice Trial Report
Lawsuit claims failure of physicians to diagnose epidural abscess led to neurological injury and paralysis of 25-year-old man
The plaintiff was a 25-year-old man who suffered a significant delay in the diagnosis and treatment of an epidural abscess which resulted in permanent paraplegia and neurogenic bowel and bladder.
On 11/20/12, the plaintiff presented to the ED with complaints of severe sharp upper and mid back pain (9/10) with no specific injury. His recent medical history included, a boil removed from his buttocks and taking a long bus trip from Arizona. He had no fever and a normal WBC. He was given pain medication, and a chest x-ray. The plaintiff left AMA to pick up his daughter and returned later the same day due to ongoing and increasing back pain. The plaintiff had a temperature of 99.2. He complained of severe, sharp back pain (10/10). No new imaging was ordered. He was diagnosed with muscle spasms/strain and discharged to home with pain medication.
On 11/23/12, he returned to the same ED with complaints of moderate back pain (8/10) and vomiting with some blood. He was crying out in pain and unable to sit for vital signs. He was evaluated and examined by an ED physician assistant. He stated that the medication wasn’t working and he felt as though he couldn’t eat due to the pain. The PA ordered additional medications for pain and nausea. No additional imaging studies or blood work were ordered. The plaintiff was diagnosed with muscle spasm/strain, and discharged to home with pain medications.
On 11/24/12, the plaintiff was transferred by ambulance to the same ED. He reported two days of back pain and leg spasms and awoke this morning unable to walk due to leg numbness and abdominal pain. In triage, he complained of 10/10 back pain, painful urination and bilateral leg numbness with no new injury. He was able to move both his feet and felt pressure when his feet were touched. A bladder scan revealed approximately 725 ml of urine. MRI of the thoracic spine showed an epidural lesion involving T4-T7 and causing mild to moderate segmental cord compression.
The plaintiff underwent emergent T6-T9 laminectomy for decompression of the spinal cord and evacuation of an epidural abscess. He continued to have bilateral paralysis of both legs post-operatively. Today, the plaintiff continues to live with paralysis from the waist down and neurogenic bowel and bladder.
The plaintiff claimed the defendant PA and ED physician failed to recognize and appreciate signs and symptoms of an epidural abscess, and failed to order a timely MRI/CT scan of the spine, and emergently transfer the plaintiff to a tertiary facility where diagnostic testing and neurosurgical consultation could be obtained. Had these things been done, the paralysis and neurological injury would have been avoided.
The case settled during discovery for $2,750,000.
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