On June 21, 2018, a Michigan medical malpractice jury returned its verdict in favor of the defendant neurosurgeon in a Michigan medical malpractice case in which the plaintiff claimed that the defendant neurosurgeon negligently failed to timely diagnose and treat his cauda equina syndrome, leading to serious and unnecessary harm.
The plaintiff was injured while working as a tree trimmer on March 27, 2009. He received conservative medical treatment for his injury from a physician who later referred him for evaluation and treatment by the defendant neurosurgeon. There was a delay of three months between the referral and when the plaintiff was finally seen by the defendant neurosurgeon.
The Michigan medical malpractice plaintiff alleged that the defendant neurosurgeon negligently performed a laminotomy, foraminotomy, and discectomy on his lumbar spine at the L4 level. The plaintiff alleged that the defendant neurosurgeon negligently removed substantial bone and structures from his L4 vertebral body without identifying them and failed to identify the fratibral bodies. As a result, the plaintiff alleged that his spine was left mechanically unstable.
The plaintiff further alleged that the defendant neurosurgeon failed to perform medical testing that would have diagnosed that he was suffering from cauda equina syndrome, which led to the plaintiff developing significant neurological deficits. The plaintiff was diagnosed with cauda equina syndrome by another physician three weeks after his surgery. The plaintiff required additional back surgery that resolved his bladder and bowel incontinence.
The defense argued that there was a window of 72 hours to perform surgery after a patient experiences symptoms of cauda equina syndrome. After that window of time closes, surgery is ineffective. The defense told the Michigan medical malpractice jury that by the time the defendant neurosurgeon saw the plaintiff, that window of time had long since closed.
Cauda Equina Syndrome (CES)
The American Association of Neurological Surgeons states on its website:
The collection of nerves at the end of the spinal cord is known as the cauda equina, due to its resemblance to a horse’s tail. The spinal cord ends at the upper portion of the lumbar (lower back) spine. The individual nerve roots at the end of the spinal cord that provide motor and sensory function to the legs and the bladder continue along in the spinal canal. The cauda equina is the continuation of these nerve roots in the lumbar region. These nerves send and receive messages to and from the lower limbs and pelvic organs.
Cauda equina syndrome (CES) occurs when the nerve roots of the cauda equina are compressed and disrupt motor and sensory function to the lower extremities and bladder. Patients with this syndrome are often admitted to the hospital as a medical emergency. CES can lead to incontinence and even permanent paralysis.
Once the diagnosis of CES is made, and the etiology established, urgent surgery is usually the treatment of choice. The goal is to reverse the symptoms of neural dysfunction. Left untreated, CES can result in permanent paralysis and incontinence.
Those experiencing any of the red flag symptoms should consult a neurosurgeon as soon as possible. Prompt surgery is the best treatment for patients with CES. Treating patients within 48 hours after the onset of the syndrome provides a significant advantage in improving sensory and motor deficits as well as urinary and rectal function. But even patients who undergo surgery after the 48-hour ideal time frame may experience considerable improvement.
If you or a loved one suffered harm as a result of the failure to timely diagnose and treat cauda equina syndrome in Michigan or in another U.S. state, you should promptly seek the legal advice of a Michigan medical malpractice attorney, or a medical malpractice attorney in your state, who may investigate your cauda equina syndrome medical malpractice claim for you and represent you in a cauda equina medical malpractice case, if appropriate.
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