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On June 6, our 62-year-old client was transported by EMS to the OSU Emergency Department complaining of sharp, unrelenting pain between her shoulder blades radiating to her chest, ribs, and upper abdomen. She was a Type 1 diabetic. She was admitted for a cardiac workup. CTA ruled out cardiac pathology, as did EKG and serial troponins.The radiologist failed to appreciate subtle swelling in the T7 paraspinal area. On day 2, a hospitalist was assigned to her care. Despite generous amounts of narcotics, her pain remained a 7/10. She spiked a fever that morning and the hospitalist ordered antibiotics and blood cultures. He elicited a history of periapical abscess and ordered a panorex which, later that day, showed an abscess. Despite these findings, he failed to order an MRI to rule in/out musculoskeletal etiology for her pain. The morning of day 3, the cultures came back positive, and still no MRI was ordered. At 6:30 a.m. on day 4, our client was found to be paralyzed from the waist down and STAT MRI was ordered, showing a circumferential epidural spinal abscess from T7-T9. Decompression surgery was unsuccessful in returning her to normal motor function or bowel and bladder function.
Defense retained the following expert witnesses: a radiologist who opined that standard of care was not breached in failing to appreciate the subtle finding of swelling on the CTA; a neurosurgeon who opined that the radiological finding was too subtle and that the standard of care did not require an MRI to be ordered without findings of neurological deficits; a PM&R specialist who also offered opinions in life care planning—he opined that despite unrelenting neurogenic pain and spasms which were not responsive to medication, plaintiff could be independent in all areas and would only need 4 hours of attentive care per day. Various medicare/insurance experts were also retained to opine that plaintiff would not sustain any future economic damages.
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