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Failure to Diagnose Spinal Abscess Leading to Sepsis

Mahon v. Mercy Medical Center

Sepsis MisdiagnosisThis is a hospital failure to diagnose sepsis as the result of a spinal abscess lawsuit filed in Baltimore City on March 13, 2017. It is the 122nd medical malpractice case filed in Maryland in 2017.

Summary of Plaintiff's Allegations

A 50-year-old man goes to the ER at Mercy Medical Center with severe lower back pain and leg numbness/tingling. He indicates that he has had lower back pain for two years and had a laminectomy (spinal surgery). He also says that over the past two days his pain has been increasing and he has had diarrhea. The doctor "refuses" to review previous MRI's of the man's back that he brings with him. The doctor contacts the Spine Center for a surgical consult, but the Spine Center declines as they do not take the man's insurance. As a result, he is referred to his primary care physician to get a referral. No MRI's or lab work takes place and he is discharged home with a "pinched nerve."

Three mornings later, the man calls 911 with severe back pain, nausea, and vomiting. He is transported to Baltimore Washington Medical Center. His attending physician does not see him but orders a liter of fluid and lab work. Another provider notes that the man has severe lower back pain radiating down his legs, and that he has a cough and difficulty urinating along with fever, chills, shakes, and sweating. The lab results reveal kidney dysfunction, elevated liver function, and high glucose. At this point, defendants allegedly should have realized the man is septic as he is lethargic, confused, and has slurred speech. Instead, defendants order more fluids.

Despite his vital signs, clinical presentation, and blood work, he is left in an observation bed. An EKG is done and is abnormal, but no vital signs are taken for the remainder of the afternoon. That night, defendants are told by radiology that there are irregularities in the patient's lumbar spine. Defendants are told they should do an MRI to evaluate properly. But they wait until the next morning to schedule the MRI. Unfortunately, that evening, the man starts hyperventilating.

It is ten hours after he is taken to BWMC when he is admitted to the ICU. When he arrives in the ICU, he is found be breathing rapidly, have a reduced level of consciousness, and he is dusky. He is clearly in septic shock, but the doctors wait for further imaging studies to be done the next day, without being made aware of the possible abscess on the man's spine. The following morning, the patient dies from septic shock secondary to a spinal epidural abscess.

The man's wife files this claim alleging that defendants were responsible for the man's death. They claim they mismanaged his care in failing to timely place a CVP (monitors central venous blood volume) failing to properly fluid resuscitate the man, failing to get a surgical and ID consult, and by failing to order an immediate MRI of the patient's lumbar and thoracic spine.

Additional Comments
  • There are some malpractice lawsuits that you want to bet on or bet against after reading the Complaint. In this case, the nuances of his medical records are going to be critical. This is a particularly hard case to assess without reviewing medical records.
  • This case was filed on the eve of the statute of limitations. Presumably to protect the statute of limitations, every imaginable defendant seems to be named. Eight doctors are among the 13 defendants.
  • There are many signs and symptoms of spinal epidural abscess that are also the symptoms for other things. The symptoms include fever, pain and tenderness in the back, lower extremity weakness, sensory deficits, and paralysis. The claim here not that they should have immediate known it was a spinal epidual abscess. Instead, plaintiff is alleging that should have made immediate efforts to rule out a spinal epidural abscess and, in that process, would have discovered the condition.
  • An abscess is a pocket of purulent material or pus which can occur almost anywhere in the human body. A spinal epidural abscess is a pocket or collection of pus which develops in or around the epidural space in the spinal column. Plaintiff is likely to argue that the appropriate treatment would have been to both give antibiotics and surgically drain the pus to relieve the pressure or compression to the spinal cord. Relieving the compression will hopefully restore blood flow to the tissues of the compressed area of the cord.
  • Baltimore City
  • Eight doctors
  • Two physician's assistants
  • Maryland Spine Center
  • Mercy Medical Center
  • Baltimore Washington Medical Center
Hospitals Where Patient was Treated
  • Mercy Medical Center
  • Baltimore Washington Medical Center
  • Failing to order a lumbar and thoracic MRI
  • Failing to perform blood work assessing for infection or inflammation
  • Failing to provide a neurosurgical consult
  • Failing to timely order blood work
  • Failing to diagnose sepsis
  • Failing to timely order antibiotics
  • Failing to properly communicate with the ICU team
  • Failing to follow the recommendations of radiology
Specific Counts Pled
  • Wrongful Death
Plaintiff's Experts and Areas of Specialty
  • None at this time
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