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Failure to Diagnose Spinal Epidural Abscess -- $1 Million Settlement

Our medical team was instrumental in helping us achieve a settlement in one of the most complex cases that our firm has ever litigated. Our client was a sixty year old male who was rendered paraplegic because of a late diagnosis of spinal epidural abscess (SEA). We obtained damages recovery from five board-certified physicians who practiced in four separate medical specialties (hospital medicine, internal medicine, rheumatology and orthopedic surgery) to conclude the settlement. SEA is a rare diagnosis seen only in one in ten thousand hospital admissions. It constitutes a neurosurgical emergency. Time is of the essence and prompt treatment makes the difference between paralysis and full recovery. The challenge in the case was to convincingly show that five highly-qualified physicians were negligent in failing to make this rare diagnosis.

Our theme in the case centered on the idea that the diagnosis would have been made if not for the failures of the five defendant physicians who neglected to properly work up the patient. That the diagnosis was capable of being timely made was dramatically illustrated by one of the defendant physicians who had, in fact, performed a proper work up of the patient and made the diagnosis before the patient had sustained any neurologic injury. This physician properly observed that the client was exhibiting the hallmark signs and symptoms of SEA – including severe, intractable back pain, fever and chills. Elevated C-reactive protein and an elevated sedimentation rate can also be seen with SEA. MRI of the spine can be used to confirm the diagnosis. This physician, a specialist, failed to arrange for immediate surgery. Instead, the physician-specialist sent a report to the client’s primary care physician that was lost on the PCP’s desk. The opportunity to successfully manage the SEA through immediate surgery and the use of IV antibiotics was then lost.