Failure to Monitor Patient’s Neurological Status While Intubated Results in Paralysis
Trial Lawyer's Report: William Thompson, Plaintiff's Attorney, Providence Superior Court
The plaintiff was a 46-year-old male who was admitted to the hospital for pneumonia. He was emergently intubated for a decompensating respiratory status secondary to a worsening pulmonary infection. Several days later he was extubated. He continued to have a fever, acute renal failure, respiratory alkalosis, an elevated white blood cell count, and difficulty breathing. He was re-intubated again for a period lasting approximately three days. When he was extubated the second time, he woke up with no feeling or movement in his lower extremities.
An MRI of the spine showed a spinal mass, measuring 1.3 x 0.9 x 3.1cm in the T11-T12 aspect of the spinal cord and high T1 and low T2 signal suggesting hemorrhage or proteinaceous material. The patient was taken to the OR urgently. The patient underwent a decompressive laminectomy of T12-T11 with durotomy and evacuation of intrathecal abscess and hematoma. Post-operatively, he had flaccid bilateral lower extremities and an absent plantar reflex.
The plaintiff claimed that while he was intubated, the defendants should have stopped the sedation at least every four hours to perform a complete neurological examination, including a pain assessment and plantar flexion response. Had this been done, the neurological compromise would have been discovered sooner, and the patient would have had a better outcome. The longer spinal cord impingement exists, the greater the likelihood for permanent neurological injury.
The defendants contended that they met the standard of care and that nothing they did or failed to do was the cause of the patient’s paralysis.
The plaintiff was unmarried. He did not have a meaningful earnings history, and was not employed during the litigation. He was able to complete all tasks of daily living, including cooking, feeding, bathing, and dressing himself, and caring for his personal needs and hygiene. He could drive and was able to live independently.
The lawsuit was settled at mediation following extensive written discovery, and numerous depositions.
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