A spinal epidural abscess ("SEA") is a disorder caused by infection inside the spine. This infection is caused by bacteria or fungal organisms, usually after a surgical procedure.
Failure to diagnose a spinal abscess may result in a medical malpractice case. Why? Because more often than not, the infection could have been controlled, if the doctor or nurse did not violate the standard of care. There is literature to prove that doctors have cautioned other doctors by saying, essentially, if you delay diagnosing a spinal epidural abscess, you are going to get sued.
An epidural abscess is a localized collection of pus between the duramater and the skull or vertebral column. Spinal epidural abscesses are almost always manageable when caught in an early stage. However, paraplegia, quadriplegia or death can result, if the diagnosis is not promptly made and treatment is not initiated.
Like many things, the key is to catch it early. If the symptoms are there and a doctor or nurse fails to diagnose, you more than likely have a viable malpractice case.
The sequential evolution for spinal epidural abscess misdiagnosis tragedy often goes like this:
- back pain (over 50% of the time and usually as the first symptom) with tenderness on examination and/or localized spinal pain
- radicular pain due to nerve root irritation may cause pain the abdomen orchest, or paresthesias, or both;
- spinal cord dysfunction, characterized by defects of motor, sensory or sphincter function, and lastly
Those first symptoms can also include fever, bowel or bladder problems, and pain, usually at the surgical site.Failure to Diagnose Spinal Epidural Abscess
Doctors, including emergency room physicians, have been trained to rule out a spinal epidural abscess when the patient presents with symptoms that would cause a reasonable doctor to be on alert.
SEA often presents with a complaint of neck pain radiating to the abdomen, and/or flank pain. SEA is frequently accompanied with a fever (about 33%). The big complaint is pain, usually accompanied by local tenderness at the affected area. Typically, specific neurological signs depend on the level of the spinal cord involvement.Clinical Markers to Verify SEA Diagnosis
If a doctor has any SEA suspicions, there are easy clinical markers that can help verify, if the patient is at grave risk of SEA. These markers consist of (1) a community acquired staphylococcus aureus bacteremia (SAB); (2) skin lesions suggesting acute systemic infection; (3) the presence of fever at 72hrs; (4) a positive blood culture at 48 hrs.
If there is a positive finding for SAB, doctors are required to follow an algorithm consistent with the article “Clinical Identifiers of Complicated Staphylococcus Aureus Bacteremia."Getting an MRI
An MRI can provide a lot of answers. An MRI can allow a good screening for SEA without a great risk, unlike lumbar punctures and myelograms. An MRI can show epidural infections promptly and at an early stage of disease when neurological deficit is more likely to be reversible.
Conversely, a delaying decompression and antibiotic treatment for SEA results in poor outcomes and permanent neurological damage. Therefore, SEA medical malpractice cases are frequent because the key prognostic factor for a favorable outcome for the patient is early diagnosis and treatment.Value of These Cases
What is the average settlement value of a spinal epidural abscess claim? One malpractice insurer reported paying $754,000 in SEA claims. You should not rely on this information, because every case really is different. Although, people still want some statistical idea of what to expect with SEA claims - this gives you some indication of how these claims are being valued when the insurance company -- or a jury -- believes the doctor made a mistake.Getting a Lawyer
If you or a loved one has suffered a spinal epidural abscess as the result of a delay in diagnosis or treatment, call our experienced medical malpractice legal team at Miller & Zois. We can help you get the compensation you deserve for the mistakes that were made.
Call 800-553-8082 today or get a free on-line case evaluation. There is no cost of any kind for this review and you only pay us if we get a financial recovery for you.