Neck Fractures Go Undetected After a Fall

Cases reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.

A 64-year-old Alabama man, while dismounting from a dolly at work, lost his footing and fell back-first, landing on his shoulders but also striking the back of his neck and the back of his head. He later reported that he felt his neck pop before he lost consciousness. A coworker found the injured man, and he was quickly evaluated by a nurse in the employer’s medical office. No bumps or bruises were found, and the patient was given acetaminophen and instructed to rest on a heating pad for half an hour or so. He rested for some additional time before returning to work.

When the man arrived home that evening, he went to sleep. When he awoke, he was experiencing significant neck pain and he was taken to an emergency department (ED). He was treated in the ED by Dr. E. X-rays were taken, but they revealed nothing. The plaintiff was discharged after administration of pain medication, a muscle relaxer, and an anti-inflammatory agent.

The following day, the patient had trouble walking and using the bathroom. He was taken to Dr. J., who ordered an MRI that was performed three days after the patient’s accident. The day after the MRI, the patient was unable to get out of bed or move his legs, and his neck pain had worsened. He was taken by ambulance to a hospital, where additional x-rays were taken. Two fractures were found in his neck, which were exerting pressure against the spinal cord. The man was also diagnosed with a bruise on the spine on the back of the neck. He underwent surgery, but his disability persisted.

The plaintiff alleged negligence in the medical providers’ failure to make an earlier diagnosis of the spinal cord injury. The plaintiff claimed that a timely diagnosis and treatment with steroids would have changed his outcome.

The defendants claimed that no negligence was involved and that the plaintiff’s outcome would have been the same, even with earlier treatment. The only defendant at trial was Dr. E.

Outcome
The patient died in 2008, and his estate was substituted as plaintiff. According to a published report, a defense verdict was returned.

Comment
In this defense verdict, it appears that everyone did the right thing, but that technology failed to properly identify the real injury. On the day of the unwitnessed accident, the patient’s physical exam revealed no findings suggestive of spinal injury. Signs and symptoms that developed on the day after the accident were suggestive of spinal injury, but x-rays ordered by the defendant emergency physician failed to reveal any abnormality; the patient’s symptoms could easily have been explained by muscle pain and soreness attributable to his accident. Certainly, in retrospect, everyone wishes that an MRI had been performed on Day 1. —JP

Cases reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.

A 64-year-old Alabama man, while dismounting from a dolly at work, lost his footing and fell back-first, landing on his shoulders but also striking the back of his neck and the back of his head. He later reported that he felt his neck pop before he lost consciousness. A coworker found the injured man, and he was quickly evaluated by a nurse in the employer’s medical office. No bumps or bruises were found, and the patient was given acetaminophen and instructed to rest on a heating pad for half an hour or so. He rested for some additional time before returning to work.

When the man arrived home that evening, he went to sleep. When he awoke, he was experiencing significant neck pain and he was taken to an emergency department (ED). He was treated in the ED by Dr. E. X-rays were taken, but they revealed nothing. The plaintiff was discharged after administration of pain medication, a muscle relaxer, and an anti-inflammatory agent.

The following day, the patient had trouble walking and using the bathroom. He was taken to Dr. J., who ordered an MRI that was performed three days after the patient’s accident. The day after the MRI, the patient was unable to get out of bed or move his legs, and his neck pain had worsened. He was taken by ambulance to a hospital, where additional x-rays were taken. Two fractures were found in his neck, which were exerting pressure against the spinal cord. The man was also diagnosed with a bruise on the spine on the back of the neck. He underwent surgery, but his disability persisted.

The plaintiff alleged negligence in the medical providers’ failure to make an earlier diagnosis of the spinal cord injury. The plaintiff claimed that a timely diagnosis and treatment with steroids would have changed his outcome.

The defendants claimed that no negligence was involved and that the plaintiff’s outcome would have been the same, even with earlier treatment. The only defendant at trial was Dr. E.

Outcome
The patient died in 2008, and his estate was substituted as plaintiff. According to a published report, a defense verdict was returned.

Comment
In this defense verdict, it appears that everyone did the right thing, but that technology failed to properly identify the real injury. On the day of the unwitnessed accident, the patient’s physical exam revealed no findings suggestive of spinal injury. Signs and symptoms that developed on the day after the accident were suggestive of spinal injury, but x-rays ordered by the defendant emergency physician failed to reveal any abnormality; the patient’s symptoms could easily have been explained by muscle pain and soreness attributable to his accident. Certainly, in retrospect, everyone wishes that an MRI had been performed on Day 1. —JP

Cases reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.

A 64-year-old Alabama man, while dismounting from a dolly at work, lost his footing and fell back-first, landing on his shoulders but also striking the back of his neck and the back of his head. He later reported that he felt his neck pop before he lost consciousness. A coworker found the injured man, and he was quickly evaluated by a nurse in the employer’s medical office. No bumps or bruises were found, and the patient was given acetaminophen and instructed to rest on a heating pad for half an hour or so. He rested for some additional time before returning to work.

When the man arrived home that evening, he went to sleep. When he awoke, he was experiencing significant neck pain and he was taken to an emergency department (ED). He was treated in the ED by Dr. E. X-rays were taken, but they revealed nothing. The plaintiff was discharged after administration of pain medication, a muscle relaxer, and an anti-inflammatory agent.

The following day, the patient had trouble walking and using the bathroom. He was taken to Dr. J., who ordered an MRI that was performed three days after the patient’s accident. The day after the MRI, the patient was unable to get out of bed or move his legs, and his neck pain had worsened. He was taken by ambulance to a hospital, where additional x-rays were taken. Two fractures were found in his neck, which were exerting pressure against the spinal cord. The man was also diagnosed with a bruise on the spine on the back of the neck. He underwent surgery, but his disability persisted.

The plaintiff alleged negligence in the medical providers’ failure to make an earlier diagnosis of the spinal cord injury. The plaintiff claimed that a timely diagnosis and treatment with steroids would have changed his outcome.

The defendants claimed that no negligence was involved and that the plaintiff’s outcome would have been the same, even with earlier treatment. The only defendant at trial was Dr. E.

Outcome
The patient died in 2008, and his estate was substituted as plaintiff. According to a published report, a defense verdict was returned.

Comment
In this defense verdict, it appears that everyone did the right thing, but that technology failed to properly identify the real injury. On the day of the unwitnessed accident, the patient’s physical exam revealed no findings suggestive of spinal injury. Signs and symptoms that developed on the day after the accident were suggestive of spinal injury, but x-rays ordered by the defendant emergency physician failed to reveal any abnormality; the patient’s symptoms could easily have been explained by muscle pain and soreness attributable to his accident. Certainly, in retrospect, everyone wishes that an MRI had been performed on Day 1. —JP