Cauda Equina Diagnosis Delay Leaves NH Woman with Permanent Neurologic Injuries

New Hampshire Medical Malpractice Settlement

The plaintiff is a 50-year-old New Hampshire woman who suffers from significant weakness of her lower extremities and bowel and bladder incontinence from a delay in the diagnosis and treatment of cauda equina syndrome.

On February 23, 2011, the plaintiff presented to her primary care doctor’s office complaining of pain in her right leg and lower back pain for the prior two weeks. She also reported that her leg pain radiated from her lower back, down her leg, to her toes. On exam, the defendant noted tenderness in the L4-L5 region of her back. Of particular note, this is the exact same location where the patient’s disc herniation and cauda equina syndrome was eventually diagnosed.

Without requesting a consultation or performing a single imaging study, the defendant physician diagnosed the plaintiff with lumbar disc disease and sciatic syndrome. She was given a prescription for cyclobenzaprine (Flexeril) and prednisone with instructions to return in two weeks for re-evaluation.

Approximately one week later, March 4, 2011, the plaintiff’s husband called the defendant’s office and reported that his wife was experienced worsening back pain, muscle spasms, and lower extremity weakness with numbness and tingling.

Later the same day, the plaintiff was seen again by the defendant.  She reported increased lower back pain with pain radiating to her legs which had worsened over the prior two days. The plaintiff also reported difficulty walking due to bilateral leg weakness, numbness, and tingling.

The defendant diagnosed the plaintiff with lumbar disc disease and prescribed cyclobenzaprine 10 mg TID, oxycodone 5 mg every 4-6 hours, prednisone, and physical therapy.

The very next day, March 5, 2011, the plaintiff presented to St. Joseph’s Hospital with an inability to walk, numbness in both lower extremities, and incontinence. An MRI was ordered and showed a very large disc herniation at the L4-L5 level completely obliterating the thecal sac (the membranous sheath that surrounds the spinal cord). Based on the MRI findings, neurosurgical evaluation at Lahey Clinic, Burlington, was recommended for cauda equina syndrome. The plaintiff was transferred to Lahey Clinic where she underwent a complete L4 laminectomy and bilateral L4-L5 diskectomy.

Today, the plaintiff suffers from significant weakness of her lower extremities with severely antalgic gait. She has difficulty with bowel retention and suffers a neurogenic bladder with incontinence.

To learn more about cauda equina syndrome, please see this recent post on our Patient Safety Blog on Cauda Equina, related to this case.

Lubin & Meyer PC - New Hampshire's Leader in Medical Malpractice Law. Attorneys practicing in MA, NH and RI.

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