[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"http:\/\/pkblawfirm.com\/blog\/spinal-epidural-abscess-a-time-sensitive-diagnosis\/#BlogPosting","mainEntityOfPage":"http:\/\/pkblawfirm.com\/blog\/spinal-epidural-abscess-a-time-sensitive-diagnosis\/","headline":"Spinal Epidural Abscess: A Time Sensitive Diagnosis","name":"Spinal Epidural Abscess: A Time Sensitive Diagnosis","description":"Katie’s Story: A Life Forever Changed by Spinal Epidural Abscess A Joyful Day Takes a Terrifying Turn Katie*, a healthy 35 year old mom of two, is celebrating the fourth of July with her family, swimming in the pool with her daughters. As she steps out of the pool, she notices that her toes and […]","datePublished":"2024-06-21","dateModified":"2025-02-20","author":{"@type":"Person","@id":"http:\/\/pkblawfirm.com\/blog\/author\/olivia-kronenberg\/#Person","name":"Oliva Kronenberg","url":"http:\/\/pkblawfirm.com\/blog\/author\/olivia-kronenberg\/","identifier":33,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/e8110e1ed46e7cf9196d14af8119fc49fbc4dbae40ee3706d145c6e58f43152e?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/e8110e1ed46e7cf9196d14af8119fc49fbc4dbae40ee3706d145c6e58f43152e?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Paul Knopf Bigger","logo":{"@type":"ImageObject","@id":"http:\/\/pkblawfirm.com\/wp-content\/uploads\/2023\/06\/Logo_PKB-2.svg","url":"http:\/\/pkblawfirm.com\/wp-content\/uploads\/2023\/06\/Logo_PKB-2.svg","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"http:\/\/pkblawfirm.com\/wp-content\/uploads\/2024\/06\/Spinal-Epidural-Abscess-A-Time-Sensitive-Diagnosis.png","url":"http:\/\/pkblawfirm.com\/wp-content\/uploads\/2024\/06\/Spinal-Epidural-Abscess-A-Time-Sensitive-Diagnosis.png","height":720,"width":1280},"url":"http:\/\/pkblawfirm.com\/blog\/spinal-epidural-abscess-a-time-sensitive-diagnosis\/","about":["Medical Malpractice"],"wordCount":1191,"keywords":["Medical Malpractic","Spinal Epidural Abscess"],"articleBody":"Katie’s Story: A Life Forever Changed by Spinal Epidural AbscessA Joyful Day Takes a Terrifying TurnKatie*, a healthy 35 year old mom of two, is celebrating the fourth of July with her family, swimming in the pool with her daughters. As she steps out of the pool, she notices that her toes and feet are numb. While her mom watches her kids, she heads inside to change out of her swimsuit. When her ankles start to feel numb, she gets worried. They head to the hospital.Katie has no idea that her life is about to change forever. A week later, she\u2019ll find herself in a neuro ICU, being told that she will probably never walk again. She\u2019ll have to learn a lot of new things, like how to self-catheterize, since she can no longer hold her own urine. She\u2019ll have to learn how to navigate life without the use of her legs. \u00a0She\u2019ll find out that her home simply wasn\u2019t designed for someone in a wheelchair: the doorways are too narrow, the cabinets and counters too high. The beautiful garden tub she used to love soaking in is now a useless deathtrap.The Shocking Diagnosis: Spinal Epidural AbscessA bacterial infection seeded in the \u201cdura\u201d of Katie\u2019s spine\u2013 a tubular membrane that encases the spinal cord. That infection created an abscess, or a collection of pus, that was pressing against Katie\u2019s spinal cord, causing the numbness in Katie\u2019s feet. The longer it\u2019s there, pressing on her spinal cord, cutting off oxygen-rich blood supply, the worse her prognosis for recovery becomes.The Chain of DelaysDelays in the Emergency RoomTiming is critical in cases involving delayed diagnosis of spinal epidural abscess. An ER physician can diagnose a spinal epidural abscess once he or she recognizes the possibility and orders an MRI, which will show the abscess. However, definitive treatment is rendered by neurosurgeons. There are lots of potential sources of delay in treating this time sensitive problem:ER physician does not order the proper test\u2014an MRI\u2014which will show the abscess;MRI isn\u2019t available at the facility at all;MRI isn\u2019t available in a timely manner\u2014either because it isn\u2019t staffed with available technicians, or because the test wasn\u2019t prioritized (ordered STAT);Neurosurgery service is not available at the treating facility, and the patient must be transferred elsewhere;Neurosurgery services are limited at the hospital\u2014maybe there\u2019s only 1 neurosurgeon on call\u2014and they aren\u2019t responding quickly to the emergency;Not all of these \u201cdelays\u201d are necessarily negligent. For instance, many hospitals have no neurosurgery services, or have very limited neurosurgery services. This is understandable in many communities, particularly rural ones. However, not having access to a service means hospitals should be prepared to transfer a patient as quickly as is reasonably possible. Similarly, hospitals that make financial decisions to only have MRI services available at certain hours of the day must make arrangements to perform those services quickly when patients have emergency need of those services \u201cafter hours.\u201dThe Critical Role of MRI Availability & Transfer DilemmaAs the hours wore on at her local hospital, the numbness slowly crept up her spine until it reached her chest. Finally, a neurologist who was asked to see the patient ordered an MRI. Unfortunately, however, the MRI wasn\u2019t staffed at night, and it wasn\u2019t until the morning that Katie\u2019s MRI was performed, showing the massive abscess pressing on her spine. At that point, because a neurosurgeon wasn\u2019t available at the local facility, the hospital needed to transfer her to a local facility that had a neurosurgeon willing to accept her and perform surgery.As you can see, numerous delays played into Katie\u2019s case. While Katie rushed to get care promptly, the ER physician didn\u2019t suspect her of having an epidural abscess, and failed to \u201crule out\u201d this \u201cdon\u2019t miss\u201d diagnosis by not ordering an MRI. Physicians are trained on the classic \u201ctriad\u201d of symptoms: fever, back pain, and neurologic deficits. However, this \u201cclassic\u201d triad is a misnomer, because patients rarely present with all three symptoms.Katie, for instance, lacked a fever. Physicians are also trained that a common pathway for bacteria to enter the dura is through intravenous drug use, and therefore, the diagnosis becomes more likely in someone who reports IV drug use. However, while IV drug use is one way that bacteria can enter the dura, it\u2019s not the only way. Any open wound\u2014even something as minor as an ingrown toenail or cut\u2014could be a pathway for bacteria to enter the blood stream. Often, the source of the infection remains unknown.A second delay came into play when the MRI that was ordered by a neurologist who was consulted was not ordered \u201cstat.\u201d Because it was night time, the MRI suite was not staffed, and technicians were only called in for emergent tests. Thus, the MRI was delayed until the following morning.A third delay came into play when the hospital wasted time trying to transfer Katie to an in-network facility. Only fifteen minutes down the road, a competitor hospital offered neurosurgery services, and Katie could have been transferred there in an ambulance, but that facility wasn\u2019t called. Instead, a hospital call center spent hours speaking with other hospitals owned by the same company, to see if they had neurosurgeons available.Legal and Medical Perspectives Regarding a Spinal Epidural AbscessAssessing the DelaysWhile all of these delays are compelling and tragic, as lawyers, we must also understand the science. At a given point in any patient\u2019s care, it becomes too late to make a difference. The most important delays in Katie\u2019s case were the ones that occurred in the emergency department, because at that point, her numbness had just began and was just in her feet. The best indicator of a patient\u2019s outcome is their condition just prior to surgery. Therefore, even though the delays later on in the story are frustrating, it would be much harder to prove they made a difference in her outcome. These issues are frequently the subject of great debate among neurosurgery experts.The Importance of Timely Medical AttentionTiming is everything in spinal epidural abscess cases. While this article focuses on hospital and physician delays, it\u2019s also important for patients to get medical attention quickly. When a patient presents with symptoms that have been present for months, there is little a surgery can do to improve their condition, although it may still be indicated to prevent symptoms from getting worse.If you or a loved one has been left with life-changing impairments after surgery to address a spinal epidural abscess, we highly recommend you contact an experienced medical malpractice attorney at Paul | Knopf | Bigger to review the specific facts of your case and carefully examine the care you received. \u00a0We were able to help Katie and her family get the financial help they needed to adjust to their new normal as comfortably as possible.*Katie\u2019s name has been changed"},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blog","item":"http:\/\/pkblawfirm.com\/blog\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Spinal Epidural Abscess: A Time Sensitive Diagnosis","item":"http:\/\/pkblawfirm.com\/blog\/spinal-epidural-abscess-a-time-sensitive-diagnosis\/#breadcrumbitem"}]}]