When clients wonder if their spinal complications fit the legal definition of malpractice there are two basic categories to consider. Spine and spinal cord malpractice lawsuits tend to involve either a mistake made during surgery or the failure to accurately diagnose the sources of the back pain & its related symptoms. The following are some of the most common examples our clients have brought to our attention.
A spinal epidural abscess happens when there’s swelling and inflammation near the spinal cord. Typically, the swelling is caused by a bacterial infection, that has entered the hollow space around the spine. That swelling can pinch the spinal cord or connective nerves, leading to severe and permanent injuries, ranging from paralysis to loss or limitations in bodily functions. Sometimes, an infection made it into the epidural space as the result of an injury, trauma, surgery, or an injection. Many spinal abscesses are caused by improper injections, such as spinal taps taken without fully sterilizing the surface of the skin or injections of steroids or anesthesia that is administered too close to the spine.
As an article in the New England Journal of Medicine noted more than a decade ago, “Spinal epidural abscesses are often initially misdiagnosed, particularly in neurologically intact patients.” It is a common practice for some doctors to consider many other diagnoses before considering an abscess. Unfortunately, many doctors, including specialists with advanced training, assume that patients can’t have an epidural abscess without the “clinical triad” of back pain, fever, and neurological deficit. Only a tiny percentage of clients with a spinal epidural abscess will have all of those symptoms.
In reality, any patient with suspicion of an infection and neurological symptoms like pain, tingling, or weakness should be evaluated for a spinal epidural abscess. Some physicians will mistakenly assume that a lumbar puncture will give them a definitive answer. Medical studies have shown that spinal taps are rarely useful in this situation. It would be better to perform a CT or MRI of the spine and the abdominal area, because these tests offer more ways to clarify the nature and extent of the damage.
If a spinal epidural abscess is found, the treatment needs to be rapid. If antibiotics are not given in time there is a risk of temporary or permanent neurological injury. If a spinal decompression procedure is not given in a timely manner, the delicate spinal cord can become more damaged over time.
Another difficult to pinpoint back condition is known as a, “burst fracture.” These occur after an accident or injury when a vertebrae is compressed or crushed. These types of fractures may be suspected in case such as a fall from a height or a car accident. The difference between a “burst fracture” and a “compression fracture” comes from the shape of the vertebrae after the injury: if the vertebrae is crushed towards the front, it’s a compression fracture, but if it’s crushed all around, it’s a burst fracture. Burst fractures are far more dangerous because the fracture can bruise or sever the spinal cord, causing paralysis or injuries to the nerves. Additionally, burst fractures tend to be “unstable,” meaning they are more likely to progress further. Unfortunately, many times burst fractures are misdiagnosed as compression fractures or as degenerative disc disease, and after that misdiagnosis the patient is often discharged from the hospital before a surgery and without any efforts to stabilize their spine. That puts the patient at great risk, because the burst fracture can get worse at any time, and, when it does, it can injure the spinal cord, causing permanent injury.
Another commonly misdiagnosed back condition is a spinal cord tumor (cancerous or benign) come in several types, but they produce similar symptoms, including:
- back pain that prevents sleeping
- muscle weakness or numbness in arms or legs, and
- bladder or bowel trouble.
Many medical conditions can cause these same conditions, which it is why doctors need to order an MRI to rule out the possibility of a tumor. If this is not done, proper treatment is delayed or by the time correct diagnosis is made the client has suffered permanent injury.
In addition to misdiagnosis, because over half a million Americans chose to have back surgery annually, just for lower back issues. These procedures are very profitable for orthopedic surgeons and hospitals, and numerous studies have shown that more than $500 million a year is spent on unnecessary back surgeries. Even when it is necessary for these procedures to be performed, many of them are done incorrectly, causing serious injuries. A review of spinal surgery malpractice lawsuits found the most common cause for a lawsuit was “improper performance after surgery.”
In addition, because all spinal surgeries require a patient be put under general anesthesia, there are these additional risks: respiratory complications, brain damage from hypoxia, and death.
In our experience, most orthopedic surgery malpractice involves at least one of the following:
- Surgical Error: During a spinal surgery, a patient’s vital signs are monitored closely, but there are two other issues that require constant attention. First, the leads to electronic monitoring of nerve signals by a technician can be placed incorrectly or not adequately supervised. Also, given how extensive spinal surgery is, anesthesia monitoring, such as for blood loss and proper oxygenation, can mean the difference between a successful operation and severe injuries including blindness or a stroke. For example, allowing a patient to become dehydrated during an operation dramatically increase the risk of a stroke.
- Operating Blindly: There is an old saying in surgery, “don’t cut what you can’t visualize.” The meaning of this phrase is simple: if a surgeon can’t see what they are doing, they shouldn’t assume they are doing it right. Many parts of an operation involve a surgeon implanting a product (like spinal screws) or cutting tissue (like adhesions) with low visibility, and many surgeons, in a hurry to get through the operation and go to the next case, simply assume they are performing the procedure correctly. But every person’s anatomy is different, and the surgery itself moves organs and tissue around in the body. Moreover, an error in the surgery doesn’t have to mean permanent injury for the patient: many times, a simple CT scan can show what has happened and reveal how to fix it, but such a repair has to be done immediately to prevent permanent injuries like nerve damage.
- Operating on Patients With Dangerous Comorbidities: Spinal surgery is invasive and prolonged. Because of that, the orthopedic surgeon must pay careful attention to whether or not the patient will be able to tolerate the procedure. Many malpractice cases involve orthopedic surgeons who operated on patients with diabetes, morbid obesity, hypertension, sleep apnea, or coronary disease without first getting clearance from other specialists, like a cardiologist or a pulmonologist. In many cases, it is not enough for a surgeon to simply review the results of EKG or stress testing themselves. If you are unsure if you or a loved one has a case of spinal malpractice, call an attorney, like a personal injury lawyer, today.