Neurosurgery Expert Witness: Patient Suffered Critical Delay in Cauda Equina Syndrome Treatment

Case Overview

This case involves a patient who presented to the emergency room with back pain, saddle anesthesia, and incontinence, suspicious for cauda equina syndrome. At the hospital, the patient’s diagnosis was confirmed, however there were no neurosurgeons present to consult or treat the patient. It was noted that there was a neurosurgeon on-call at the time, however she did not report to the hospital for over 24 hours after being informed of the patient’s condition. Upon the patient’s arrival, the physician did not order an MRI or any other immediate treatment. The patient ultimately underwent surgery several days later at a different institution, well after the optimal window of treatment for patients with cauda equina syndrome had passed. As a result, the patient suffered permanent injuries including pronounced lower limb dysfunction

Questions to the Neurosurgery expert and their responses

Do you routinely treat patients similar to the one described in the case? Please explain.

I have 20 years of experience practicing neurosurgery in academic and veterans hospitals. I have evaluated and operated on numerous patients with cauda equina syndrome.

Have you ever had a patient develop the outcome described in the case?

I have been in practice since 1995, when I completed my neurosurgery residency, and during my 20 years of practice I have evaluated and operated on numerous patients with cauda equina syndrome.

Do you believe there may have been a deviation in the standard of care that contributed to this patient's poor outcome?

It appears that the patient failed to receive timely neurosurgical intervention that might have prevented or reduced any subsequent permanent neurologic deficit.

About the expert

This highly qualified Neurosurgery expert received his medical degree from the highly regarded Yale University School of Medicine and went on to complete postgraduate training at the prestigious University of Pennsylvania. He is board certified by the American Board of Neurological Surgery and is a member of numerous professional organizations including the Congress of Neurological Surgeons. He has published 49 peer-reviewed journal articles and authored 10 books and book chapters in his field. His research projects have attracted over a million dollars in funding, and he is frequently invited to lecture as a guest speaker at engagements throughout the country. He currently holds academic, administrative and clinical appointments at an ivy league university.