Failure to diagnose

A 62 year old woman went to a local hospital after an MRI ordered by her primary care doctor revealed a severe infection in her spine. She was admitted to the hospital and was attended to by 3 doctors, including a hospitalist, infectious disease consultant, and a neurosurgeon. A cat scan was ordered to confirm the nature and extent of spinal infection, which it did, and also revealed the presence of a spinal abscess. Despite these findings, the neurosurgeon signed off on her care and advised that no further neurosurgical intervention was necessary.

The patient remained in the hospital for another 7 days during which time no additional diagnostic studies including MRI, CT scan, or blood work were performed to evaluate the status of the infection. The patient was then discharged with instructions to follow up with her doctor. The patient did schedule an appointment to be seen. However, before that appointment took place the patient began suffering loss of function in her legs and immediately returned to the same hospital. The same neurosurgeon was called in who proceeded to perform emergency surgery to drain the abscess and eliminate the compression on the spinal cord caused by the infection.

Unfortunately, the surgery was done too late and the patient was left permanently paralyzed from the waist down and left incontinent of bowel and bladder. The standard of care for patients with confirmed spinal infections with accompanying abscess is immediate neurosurgical drainage and decompression of the abscess and infection. The failure of the neurosurgeon to immediately operate on the patient when she first presented and a failure of the other 2 physicians to ensure that the patient received timely and appropriate neurosurgical care caused a 10 day delay and the necessary care being provided. Had this delay not occurred, there was a high degree of probability that the infection would have been cured and the patient would have had no neurological impairment. For the remainder of her life, she will now require full time attendant care to assist with her activities of daily living, frequent skilled nursing care to assist with bowel and bladder function.

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