Doctors Fail to Detect Spinal Fracture

Rheumatology Expert WitnessThis case takes place in California and involves a female with a past medical history of Ankylosing Spondylitis. Her condition was stable and she’d been managed effectively for about one year under the care of a rheumatologist. The patient suffered an injury to her back after falling down the stairs and presented to the ER. The patient was worked up for her back pain and a CT scan revealed no new injuries. She followed up with her rheumatologist who administered several treatments to address her ongoing pain. Some time later, she presented to the ER complaining of a minor lack of sensation in her hips. The physicians decided that the patient needed an MRI. The plaintiff was sedated and forced to lay flat for the medical imaging. During the MRI the patient experienced the sudden onset of total numbness in her lower extremities. Emergent surgery was ordered which identified multiple injuries to her lower spine that had gone undetected during her initial visit to the emergency room. The patient is now a paraplegic.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients with Ankylosing Spondylitis?
  • 2. Have you published or lectured on Ankylosing Spondylitis? If so, please explain.
  • 3. Have you ever served as an expert witness on a case involving Ankylosing Spondylitis?

Expert Witness Response E-007488

I routinely treat patients with AS and have published an extensive review on the diagnosis and Rx regimens patients with AS ought to receive. Patients with AS have brittle spines so imaging was essential when this patient went to the ER. If undiagnosed, and given the other factors surrounding her medical history, she risked putting weight on a fracture of the spine with potentially disastrous consequences. That said, a great deal of caution should have been used while preparing this woman for imaging studies. There are various treatment methods for a patient like the one described, and I’d be happy to review her charts to provide an assessment of her condition and prospects for the future, had she not faced this unfortunate outcome.

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