Patient Suffers Permanent Injury Due to Positioning in MRI Machine

Case Overview

Questions to the Emergency Medicine expert and their responses

Do you believe this patient should have been sent to a trauma care unit, where she wouldn't have needed to lay flat for an MRI to be performed?

This patient clearly needs an MRI study because of concern for cauda equina syndrome and the danger of permanent paralysis. Nearly all MRI studies of the spine require the supine position.

Since her spinal condition was known and well documented, was it a departure for the ER physicians to order significant pain meds to have her lay flat?

It is not at all unusual for people with back pain to have pain when lying down, in a scanner or elsewhere. Giving pain meds to assist the study when needed is routine.

About the expert

This board-certified expert has over 35 years of experience as an emergency medicine physician. He received a M.D. from the prestigious Stanford University School of Medicine where he also served as Chief Resident in Emergency Medicine. Elected as a Fellow to the American College of Emergency Physicians, he has contributed to California state and federal legislation on various issues including inter-hospital patient transfer regulations and funding for emergency medicine. He has published several peer-reviewed journal articles, textbook chapters, and textbooks on emergency care. His previous positions have included Medical Director and Chief of Emergency Medicine. He currently serves as an Attending Physician for a health system and a major university medical center where he also serves as Clinical Professor of Surgery in the Division of Emergency Medicine.