Delay in Diagnosis Causes Permanent Nerve Damage from Cauda Equina Syndrome
The following excerpt from a Notice of Intent to File Claim, or more commonly called, “Notice of Intent to Sue,” is a recent case that the litigators at Erlich, Rosen, Bartnick & Cook P.C., have begun on behalf of one of our clients. If you wish to discuss a medical malpractice claim please contact ERBC at either www.ERBCLaw.com or 1-877-453-2840 for a free consultation.
Factual Basis for Claim
On August 17, 2006 the 36 year old Plaintiff went to Defendant After Hours Clinic and was seen there by a physician. At that time Plaintiff was suffering from low back pain and other signs and symptoms related to her back. She had a history of a back injury a number of years earlier. She was sent home with the diagnosis of lumbar strain and was prescribed pain medication.
On August 19, 2006, Plaintiff went to Defendant Medical Center and was seen by Defendant Emergency Room physicians. Plaintiff indicated that she had been through the outpatient clinic earlier and indicated the diagnosis that she was informed about on the 17th of August, 2006. While in the Emergency Room on the 19th of August, 2006 she indicated that her symptoms that she had on August 17, 2006 were more significant as far as pain and radiation of pain and that she also had numbness primarily in her saddle area. She was sent home on August 19, 2006 and told to see her family physicians.
The following day, on August 20, 2006 after contacting Defendant Internal Medicine Practice, she again went to the Emergency Room of Defendant Medical Center. At this point in time she continued to have worsening complaints as listed above, including numbness in her saddle area, pain, radiation of pain, and she now had the new complaint which had started at approximately 11:30 a.m. on the 20th of August, 2006 of difficulty and/or inability to urinate and defecate. During this Emergency Room visit she was admitted to the observation section of the Emergency Room Department.
When Plaintiff was placed into the holding area, there was a request for a neurology consult which was not ordered on a stat basis. The purpose of the consultation with neurology was to rule in or rule out multiple sclerosis. Plaintiff arrived at Defendant Medical Center at 2:40 on August 20, 2006. She remained in the Emergency Room complaining of severe pain, saddle numbness, and inability to urinate or defecate. At approximately 9:00 a.m. on August 21, 2006 Plaintiff was seen by a neurologist, to rule in or rule out the possibility of multiple sclerosis as requested from the Emergency Room physicians. It is believed when Plaintiff was still in the holding area in the Emergency Room at this point in time, a physician finally realized that the signs and symptoms were not consistent with multiple sclerosis and felt that the most likely diagnosis was cauda equina syndrome. He ordered an MRI which was accomplished sometime between 12:00 p.m. and 2:00 p.m. on August 21, 2006. After the MRI was taken and reviewed, it was immediately realized that the Plaintiff was suffering from a large herniated disk causing cauda equina syndrome. A neurosurgeon was consulted and the Plaintiff was immediately taken to surgery. As a direct result of the delay of surgery to remove pressure and injury to the spinal cord, Plaintiff is left with virtually no ability to urinate or defecate on her own instincts. She has also suffered additional pain, suffering, disability and mental anguish secondary to the delay in diagnosis and treatment of cauda equina syndrome.
If the standard of practice had not been breached by the physicians who treated the Plaintiff, the diagnosis of disk herniation and cauda equina syndrome would have been made prior to the time of permanent injury to the nerves in the spinal process of the Plaintiff. The cauda equina in this situation was caused by a herniated disk causing impingement of the spinal nerves. Time was of the essence with respect to taking pressure off the nerves so that there would be no, or limited, damage to the spinal cord and nerves. Cauda equina is a surgical emergency and the disk that was causing impingement upon the spinal process needed to be removed as soon as possible so that the pressure and potential damage to the spinal cord could have been avoided. If the proper diagnosis had been made on the 19th or 20th of August, 2006, the standard of practice would have required emergent surgery and Plaintiff’s long term damages would have been more likely than not either totally avoided or very significantly reduced.
As a direct result of the delays caused by the Defendants, Plaintiff has had urinary retention and has had to have surgery to help treat urinary symptoms. She has to self catherize herself. She has also had significant issues with defecation and must use outside methods to attempt to defecate. All of these injuries could have been avoided with the earlier and prompt treatment by the Defendants. Plaintiff has also suffered from significant mental anguish and depression secondary to her physical complaints. All of which could likely have been avoided, if the delays by the Defendants had not caused her this extensive physical injury. Plaintiff has lost employability as a result of these physical and mental damages secondary to all of the Defendants’ delay with respect to her treatment of disk herniation and cauda equina syndrome.
