Injury to the spinal cord can result in severe and profound impairment including quadriplegia, paraplegia, hemiplegia, or a less severe but still profound impairment.
The catastrophic and life-changing impairment of a spinal cord injury can involve practitioners from virtually all areas of the healthcare system, including physiotherapists, chiropractors, general practice physicians, orthopaedic surgeons, neurosurgeons, vascular surgeons, oncologists, and so on.
Many spinal cord injury malpractice cases involve the failure of one or more of the treatment providers to act with the proper level of urgency in recognizing or treating a potential spinal cord injury.
This delay may cause or contribute to the development or exacerbation of a spinal cord injury. Other cases involve a spinal cord injury which itself was caused by the negligence of health care practitioners.
Examples of this include:
Due to the fact that there are a wide variety of mechanisms for spinal cord injury, including negligent causes and non-negligent causes, spinal cord injury cases are some of the most complicated medical malpractice cases.
Whether it is at the emergency department or in a general practitioner’s office, health care practitioners are trained and expected to recognize the signs and symptoms of spinal cord injury. When a patient presents with possible spinal cord injury, health care practitioners must take necessary precautions to prevent further injury and arrange investigations (CT scans, MRI, and blood tests) to rule out the possibility of spinal cord injury.
The intent is to diagnose spinal cord injury (or conditions that could progress to spinal cord injury) as early as possible so the patient can be referred to the appropriate specialist (generally a spine surgeon trained in either orthopaedic surgery or neurosurgery) and that surgery, if necessary, can occur as quickly as possible. Once spinal cord injury is diagnosed, the goal is to preserve as much of the patient’s function as possible.
As in other medical malpractice cases, the plaintiff in a spinal cord injury case must establish that one or more of the health care practitioners provided treatment that fell below the reasonable standard of care expected in the circumstances.
In these catastrophic cases, it is often tempting for the victim and their lawyers to judge the health care practitioner based on the outcome alone (using the benefit of hindsight), as opposed to focusing on what was known to the health care practitioner and the patient at the time of the encounter. As in any medical malpractice case, it is important to recognize that while the health care practitioner(s) should not be judged with the benefit of hindsight, it is important to consider not only what the physician and patient knew at the time of the encounter, but also what should have been known had the physician taken the appropriate steps. These steps include taking a history from the patient (including family history), conducting an appropriate clinical examination, and ordering any indicated diagnostic tests. The patient and their lawyers should consider what the likely results would have been had the appropriate clinical examination and diagnostic tests been conducted.
If a patient is injured during surgery and negligence is suspected, it is often possible to verify what happened during the surgery with post-operative MRI imaging. This imaging can identify misplaced surgical hardware, the source of bleeding, or cerebral spinal fluid leaks. In these types of cases, the imaging can be reviewed by experts who can distinguish between injuries that are a risk of the procedure and may occur even in the hands of a careful and properly trained surgeon, and injuries that would normally only occur as a result of negligent care.
The next step is to prove that the spinal cord injury was caused by, or contributed to, the negligent conduct of the health care practitioner. In some cases, this analysis is straightforward, such as when the spinal cord is injured during an otherwise benign operation and the patient leaves the operating room paralyzed. In other cases, this analysis is more complicated, such as when there is a delay in diagnosis and treatment of spinal cord compression.
Establishing causation in a spinal cord injury case requires lawyers and experts to conduct a careful review of the facts relating to symptom progression, the imaging (MRI, CT scans, and ultrasounds), and the contents of the medical records. A review of this information will allow a patient’s lawyer, with the assistance of experts, to determine whether it can be established on a balance of probabilities (51% or more likely) that the outcome would have been better had the negligence not occurred.
A patient who suffers from a spinal cord injury that was caused by a health care practitioner, or whose health care team failed to act with the appropriate level of urgency to minimize the severity of the spinal cord injury, can bring claims for compensation for:
Quantifying these losses requires expert opinions from physiatrists, occupational therapists, economists, and, in some cases, life-expectancy experts.
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