Delay in IVIG Treatment Leads to Worsening Symptoms in Incarcerated Patient

Case Overview

This case involves a 58-year-old incarcerated individual with a medical history of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Guillain-Barre syndrome. The patient had been receiving intravenous immunoglobulin (IVIG) treatments intermittently since their diagnosis. Over several months, they reported progressively worsening symptoms, including loss of strength and motor control, culminating in at least three episodes of collapsing before being discharged to a hospital. Following their release, where they were diagnosed with CIDP and received a round of IVIG therapy, the patient faced further delays in care due to a failure to provide the ordered IVIG treatment. During this period, prison medical providers noted the deterioration of the patient’s condition and explicitly attributed the worsening symptoms to the lack of treatment. Expert testimony is sought to establish causation in this medical malpractice case.

Questions to the Neurology expert and their responses

How often do you manage the care of patients with chronic neurological conditions such as Guillain-Barre syndrome?

I am a quadruple board-certified neurologist with over 15 years of experience in the field. I manage the care of patients with chronic neurological conditions such as Guillain-Barre syndrome frequently in an acute setting, such as in the emergency department or Neuro ICU. Additionally, I see patients with chronic CIDP with acute on chronic decompensation very often in both the ICU and ED.

What, if any, is the extent of your experience treating prison inmates within correctional facilities or patients transferred from correctional facilities?

We are a federal center for state prisons, so I am aware that these patients are an underserved cohort that experiences undertreatment.

About the expert

This expert has over 15 years of experience in neurology, vascular neurology, neurocritical care, and critical care medicine. He earned his MD from the Universidad de Militar in Colombia, before receiving his MS in epidemiology from Columbia University and his MBE in bioethics from the University of Pennsylvania. He completed a residency in internal medicine at the Lincoln Medical Center and an additional residency in neurology. He then finished a fellowship in neurocritical care and vascular neurology, a fellowship in neuro-epidemiology at the Columbia University Medical Center, and a fellowship in internal medicine and critical care medicine at Cooper University. Today, this expert is board certified in neurology, vascular neurology, internal medicine, and critical care medicine. He is a member of several professional organizations, such as the Neurocritical Care Society. He is also very active in academia, having published over 95 abstracts, 57 peer-reviewed journal articles, and 24 textbook chapters on topics related to vascular neurology and neurocritical care. Previously, he was an instructor of neurology at Columbia University, an attending hospitalist at the Cape Regional Medical Center, and an attending neurologist at Cooper University Hospital. Most recently, this expert worked as an associate professor of neurology and neurosurgery at Thomas Jefferson University and as an attending neurologist and the director of the stroke and cerebrovascular disease department at their affiliated hospital. Currently, he serves as a professor of neurology at a medical school and as an associate attending physician of neurology and critical care at multiple medical centers in New Jersey.

E-022561

Specialties:

Neurology