Who is Liable for the Delay in Treating my Spinal Epidural Abscess?

Who is liable for the delay in treating my spinal epidural abscess?

Stealthy and sinister, spinal epidural abscesses pose a grave threat when diagnosis and treatment are both delayed. Spinal epidural abscesses are enigmatic and difficult to find, as they are concealed within the protective layers that surround the spinal cord and vertebrae. These abscesses can become debilitating as the harbored bacteria and pus begins to swell, putting pressure on the brain and spinal cord.

In instances where misdiagnosis or treatment delays occur, the line blurs between medical misfortune and malpractice, necessitating the expertise of hospital malpractice lawyers. Raynes & Lawn in Philadelphia stands ready to examine your case, determining whether a misdiagnosed spinal epidural abscess and its consequences constitute a medical malpractice incident.

Key Takeaways

  • Spinal epidural abscesses are rare but serious infections between the spinal cord’s protective covering and spine bones.
  • Early diagnosis is crucial; symptoms include localized pain, fever, neurological issues, and bladder or bowel problems.
  • Risk factors include immunodeficiency, spine trauma, blood infections, spinal bone infections, recent back surgery, and boils.
  • Timely diagnosis and treatment are essential to avoid complications like spinal meningitis, spinal cord abscesses, and permanent paralysis.
  • In cases of delayed diagnosis, patients may have grounds for medical malpractice claims. Consulting with experienced attorneys is advisable for guidance and representation.

Understanding Spinal Epidural Abscesses

A spinal epidural abscess is a rare and serious medical condition characterized by an infection that develops in the space between the protective covering (the dura mater) of the spinal cord and the bones of the spine. This space is called the epidural space. The infection usually results from bacteria, commonly Staphylococcus aureus, which enters this space and causes an inflammatory response.

Spinal epidural abscesses may also form during or after spinal surgery. However, this is rare. During spinal surgery, there is a risk of introducing bacteria or other pathogens into the surgical site, which can lead to an infection and potentially the formation of an epidural abscess. This is why strict sterile techniques are crucial during surgery to minimize this risk.

In some cases, the risk of infection can be higher if the patient has pre-existing risk factors, such as a compromised immune system, diabetes, or obesity. Additionally, the type of spinal surgery and its duration can influence the risk of infection.

Spinal Epidural Abscess Symptoms

A spinal epidural abscess typically presents with a range of symptoms that can vary in severity. While the most common symptom prompting individuals to seek medical attention is localized pain near the abscess site, other signs and symptoms may also be indicative of the presence of a spinal epidural abscess. These can include:

  • Chills: Patients with a spinal epidural abscess may experience unexplained chills, often accompanied by fever. These symptoms are typical signs of an infection within the body.
  • Nausea and Vomiting: Some individuals may experience nausea and vomiting as a result of the body’s response to the infection and the resulting pressure on the spinal cord.
  • Headaches: Headaches can be a symptom of an intracranial epidural abscess, although they may also occur with spinal epidural abscesses due to increased intracranial pressure.
  • Difficulty Walking: As the abscess compresses the spinal cord or nerves, it can lead to a range of neurological symptoms, including difficulty walking, muscle weakness, and sensory changes.
  • Fever: A fever is a common sign of infection in the body, which often accompanies spinal epidural abscesses.
  • Bowel or Bladder Incontinence: Severe cases of spinal epidural abscess can lead to loss of control over bowel and bladder functions due to nerve compression.
  • Trouble Urinating: Difficulty in initiating or controlling urination may occur when the abscess affects the nerves controlling bladder function.

Spinal Epidural Abscess Risk Factors

The development of a spinal epidural abscess is more likely in individuals with specific risk factors. These include:

  • Immunodeficiency: Weakened immune systems due to medical conditions (like HIV/AIDS), medications, or other factors can increase the risk of infection, making individuals more susceptible to developing an abscess.
  • Trauma to the Spine: Previous injuries to the spine can create pathways for bacteria to enter and lead to an infection.
  • Blood Infection: Bacteremia, which is the presence of bacteria in the bloodstream, can potentially lead to a spinal epidural abscess.
  • Infection of the Spinal Bones: Osteomyelitis, an infection of the spinal bones, can extend to cause an epidural abscess.
  • Recent Back Surgery: While uncommon, infection at the surgical site following back surgery is a risk factor for the development of a spinal epidural abscess.
  • Boil Located on the Back or Scalp: Boils can be a source of bacterial infection. If a boil is located on the back or scalp, bacteria may enter the bloodstream and travel to the spinal area, potentially leading to an abscess.

How Spinal Epidural Abscesses Are Diagnosed

Diagnosing a spinal epidural abscess often involves a combination of clinical evaluation, medical history, and diagnostic tests. When a patient presents with symptoms suggestive of an epidural abscess, the healthcare provider will typically follow a structured diagnostic process:

  • Medical History and Symptom Assessment: The doctor will inquire about the patient’s medical history, focusing on the onset and progression of symptoms. A detailed symptom assessment helps in identifying potential risk factors.
  • Physical Examination: A neurological examination will be performed to assess motor and sensory function, coordination and balance, vision, and other neurological indicators. Any changes in mood or behavior will also be assessed.
  • Imaging Studies: The primary diagnostic tools are imaging studies, particularly magnetic resonance imaging (MRI) and computed tomography (CT) scans of the spine. These imaging techniques can reveal the presence of an abscess and its location.
  • Fluid Analysis: If an abscess is identified, the healthcare provider may perform a procedure to aspirate and analyze the fluid from the abscess. This helps identify the specific causative organism, such as bacteria or fungus.
  • Blood Tests: Blood tests may be conducted to assess for signs of infection, such as elevated white blood cell count and the presence of bacteria in the bloodstream.
  • Neurological Examination: The doctor will perform a comprehensive neurological examination to assess changes in vision, balance, coordination, sensation, motor function, mood, and behavior. Any neurological deficits can provide additional diagnostic clues.

By combining these diagnostic approaches, healthcare providers can make an accurate diagnosis and initiate appropriate treatment promptly. Early diagnosis and treatment are crucial for minimizing complications associated with spinal epidural abscesses.

Treatment of an Epidural Abscess

Addressing an epidural abscess typically involves a combination of medical and, in some cases, surgical interventions to eradicate the infection and relieve pressure on the spinal cord or brain. The treatment process includes the following steps:

  • Antibiotic Therapy: Doctors prescribe antibiotics to target the specific causative microorganism behind the infection. Intravenous (IV) administration of antibiotics is common because it ensures rapid and effective delivery throughout the body, helping to combat the infection.
  • Surgical Drainage: In cases where the abscess is substantial and causing significant pressure on surrounding tissues or neurological deficits, surgical drainage may be necessary. This procedure entails the surgeon using a needle or making an incision to drain the fluid, pus, and infectious material from the abscess.
  • Abscess Removal: In certain situations, the best course of action is the complete removal of the abscess through surgical intervention. This involves excising the abscess along with the surrounding infected tissue to prevent further spread of the infection and alleviate pressure on the spinal cord or brain.
  • Treatment of Underlying Causes: Addressing the underlying conditions or risk factors that contributed to the development of the abscess is a vital part of treatment. If the infection resulted from an osteomyelitis (infection of spinal bones) or another condition, appropriate therapy is initiated to manage the primary issue.

Epidural Abscess Complications

Without prompt diagnosis and treatment, spinal epidural abscesses can lead to various severe complications, which may have long-lasting or permanent consequences. These complications include:

  • Spinal Meningitis: An untreated abscess may lead to the spread of infection within the meninges, causing spinal meningitis. This condition can result in inflammation of the protective membranes surrounding the spinal cord and brain, leading to symptoms like severe headaches, fever, and neck stiffness.
  • Formation of a Spinal Cord Abscess: A spinal cord abscess is an even more severe complication. It occurs when the infectious process directly affects the spinal cord itself. This can result in profound neurological deficits, pain, and paralysis.
  • Infection Inside the Spinal Cord: In some cases, the abscess may penetrate the spinal cord, causing infection within the cord’s tissue. This can lead to profound and often irreversible damage to the central nervous system.
  • Chronic Back Pain: Even after successful treatment, patients may experience persistent, chronic back pain as a consequence of the damage caused by the abscess and the associated surgical procedures.
  • Permanent Paralysis: Severe and prolonged compression of the spinal cord may result in permanent paralysis in some individuals. This life-altering condition can have significant implications for a patient’s independence and quality of life.
  • Risk of Death: In untreated or advanced cases, a spinal epidural abscess can be fatal, particularly if the infection spreads to the brain or systemic circulation. Timely intervention is crucial to prevent this outcome.

Because of these potentially devastating complications, the swift diagnosis and immediate treatment of spinal epidural abscesses are paramount. Early medical intervention significantly improves the chances of a full recovery and reduces the risk of complications.

Failure to Diagnose a Spinal Epidural Abscess

Spinal epidural abscesses can form when the patient has infections in other areas of the body. Urinary tract infections (UTIs) raise the risk of developing an epidural abscess. It can also be caused by spinal bone infections, boils, or blood infections. Patients with any of these conditions should be carefully monitored and treated to prevent the development of a spinal epidural abscess and quickly identify one if it forms.

A delayed diagnosis of a spinal epidural abscess is a type of medical error that might occur when a doctor is practicing medicine in emergency departments, urgent care facilities, or primary care settings. Patients might show symptoms such as chills, fever, back pain, neurological problems, or urinary and bowel changes. Since these symptoms might also indicate other conditions, a doctor might fail to include a spinal epidural abscess in the initial differential diagnosis.

A suspected spinal epidural abscess should prompt an immediate MRI or CT scan to confirm it. Once it is diagnosed, the doctor should drain the fluid or perform surgery to remove it. Without immediate medical intervention, the patient can suffer permanent neurological damage and might be left paralyzed. An untreated spinal epidural abscess could also cause the patient’s death.

The earlier a doctor diagnoses a spinal epidural abscess, the better. When a patient receives prompt treatment, the infection might be prevented from spreading or worsening. Prompt treatment can also help to ease the patient’s symptoms. A patient who receives prompt, effective treatment is normally able to regain their functioning and fully recover. However, some patients will suffer lingering issues and have to undergo rehabilitative therapy.

Liability for a Delayed Diagnosis of a Spinal Epidural Abscess

If a doctor fails to diagnose and properly treat a spinal epidural abscess, they might be liable if the abscess worsens and causes serious injuries, paralysis, or death. Doctors should include a spinal epidural abscess in a differential diagnosis when a patient presents with neurological functioning issues and back pain.

A differential diagnosis refers to the process involved in including various conditions for comparison that share some symptoms and performing tests to identify which condition is causing the patient’s symptoms. Failing to include a spinal epidural abscess in a differential diagnosis or failing to order tests to rule it out or confirm it could be medical negligence. If your doctor failed to promptly diagnose you with a spinal epidural abscess, and you suffered serious complications and injuries as a result, you might have grounds to file a lawsuit against the doctor. A medical lawsuit attorney at Raynes & Lawn can review the medical records, consult a medical expert, and provide a fair assessment of the merits of your potential claim.

Proving a Spinal Epidural Access Malpractice Claim

To win a medical malpractice claim based on a delayed diagnosis of a spinal epidural abscess, you will need to present evidence proving each of the following legal elements by a preponderance of the evidence:

  • Formation of a doctor-patient relationship
  • The doctor’s medical standard of care
  • The doctor’s treatment deviated from the medical standard of care
  • The breach of the standard of care caused your injuries
  • Actual damages

Pennsylvania law requires medical malpractice plaintiffs to consult medical experts before filing their claims. The medical expert will determine the relevant standard of care, review the medical treatment records, and make a determination about whether the doctor’s treatment deviated from the standard of care and caused the injuries the patient suffered. Your medical malpractice lawyers in Philadelphia must file a certificate of merit within 60 days of when they file a malpractice lawsuit attesting to the court that your case has undergone a review by a medical expert who can opine the doctor’s care fell below the expected standard of care and caused your injuries.

Consult Our Medical Malpractice Attorneys

If a doctor failed to diagnose your spinal epidural abscess or misdiagnosed you with a different condition, you might have grounds for filing a malpractice lawsuit. A delayed diagnosis and treatment for a spinal epidural abscess can cause permanent paralysis or death. A medical malpractice lawsuit might allow you to hold the doctor accountable for your injuries and losses.

As compared to other types of injury claims, medical malpractice lawsuits are complex. To succeed, you’ll need to have a combination of extensive legal experience and medical expertise. The team of medical malpractice lawyers in Philadelphia at Raynes & Lawn has more than five decades of experience litigating on behalf of medical negligence victims and has recovered tens of billions of dollars on their behalf. We have a network of medical experts and work closely together with them to build the strongest possible cases for our clients.

The medical malpractice attorneys at Raynes & Lawn provide free case evaluations and work on a contingent fee basis. This means you will not have to pay attorney’s fees until and unless we recover compensation for you. Call us to schedule a consultation today at 1-800-535-1797 or fill out the contact form.



For the general public:  This Blog/Website is made available by the law firm publisher, Raynes & Lawn, for educational purposes. It provides general information and a general understanding of the law but does not provide specific legal advice. By using this site, commenting on posts, or sending inquiries through the site or contact email, you confirm that there is no attorney-client relationship between you and the Blog/Website publisher. The Blog/Website should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

For attorneys:  This Blog/Website is informational in nature and is not a substitute for legal research or a consultation on specific matters pertaining to your clients.  Due to the dynamic nature of legal doctrines, what might be accurate one day may be inaccurate the next. As such, the contents of this blog must not be relied upon as a basis for arguments to a court or for your advice to clients without, again, further research or a consultation with our professionals.