Case Study: Spinal Cord Injury

Justice Obtained for Botched Epidural Steroid Injection

  • Case Type: Interventional Pain Procedure-Cervical ESI / Medical Malpractice
  • Outcome: Confidential Settlement
  • Challenge: Proving that failure to follow patient safety guidelines resulted in harm to our client

Case Summary

A  client underwent a cervical epidural steroid injection ("ESI") at a North Texas surgical hospital where contrast dye was inadvertently injected into his spinal cord necessitating emergency spinal surgery and resulting in a permanent spinal cord injury. VWMW filed a medical malpractice lawsuit against the hospital and doctors involved and successfully obtained a significant confidential settlement. 

Spinal Cord Injury Case

Case Background

  • Our client was an active, retired gentleman who underwent an elective C7-T1 epidural steroid injection to alleviate some neck pain.
  • During the procedure, the doctor attempted to visualize the tip of the needle using only an AP fluoroscopic image without confirming the depth of the needle with a side lateral view.
  • The anesthesia provider sedated our client with deep sedation so that he was unable to feel or provide any feedback in the event that the needle was place incorrectly.
  • These failures to follow standard patient safety guidelines led to the needle being inserted too deeply and contrast dye and steroid medication being injected directly into the cervical spinal cord.
  • Shortly after the procedure was completed, our client experienced increased heart rate, blood pressure, and tachypnea. In the recovery room, he coded and had to be intubated and transported to the emergency department.
  • In the emergency department, a perfusion CT revealed contrast material throughout his cervical spinal cord from the recently attempted epidural steroid injection. This was a grave prognosis leaving the surgical team hesitant to operate given the low probability of our client even surviving the procedure.
  •  Our client ultimately underwent emergency C3-C7 decompression and C2-T2 posterior fusion where surgeons discovered a large cord contusion was found.
  • Miraculously, our client survived the surgery but remained in the neurological ICU for several weeks before he was able to be transferred to inpatient rehabilitation where he underwent extensive significant PT/OT/ST rehabilitation.
  • As a result of the preventable complication, our client continues to require assistive care due to the severity of the injuries and the permanency of the upper extremity impairment sustained.

    • VWMW’s Approach and Strategy

    The case required significant discovery and testimony from several nationally recognized medical experts to establish the standard of care for multiple defendants and the role that each played in causing this catastrophic outcome.  Our investigation during discovery revealed that the doctor had attempted this procedure with AP fluoroscopy only and, thus, was unable to verify actual needle depth. It was also discovered that our client had been over-anesthetized leaving him so deeply sedated that he was intentionally left without the ability to respond to painful stimuli during the critical portions of the procedure in direct violation of ASA guidelines.


    "When sedation is provided during the performance of a pain procedure, it should allow the patient to be responsive during the critical portions of the procedure, e.g. to report any procedure-related parasthesia, acute changes in pain intensity, function, or potential toxicities.” ASA Statement on Anesthetic Care During Interventional Pain Procedure for Adults (2021)

    During discovery, we also established that the way this procedure was performed was not unique. In fact, we learned that elective ESIs were being performed with patients deeply sedated as a matter of course. This was a disaster simply waiting to happen. While the doctor and the anesthesia provider directly caused the injury, VWMW was also able to establish the hospital’s role in allowing elective ESIs to be routinely performed in violation of established patient safety guidelines. Ultimately, we were able to demonstrate that had the various providers followed patient safety guidelines, this catastrophe could have easily been prevented.

    Case Outcome

    This case underscores the importance of meticulous case preparation and in-depth understanding of the current science and medicine related to interventional pain procedures. Comprehensive investigations of the providers involved and a deep understanding of patient safety guidelines were essential to proving negligence against multiple healthcare providers and securing a favorable outcome for our deserving client. Notably, at the time this matter was resolved, the hospital’s pain management department had been shut down.  The strategies employed by VWMW ensured that our client received the justice and compensation he deserved and likely prevented another patient from experiencing a similar outcome. 

    Moving Forward Together

    If you or a loved one has been impacted by medical negligence, we are here to help. At Van Wey, Metzler & Williams, we fight tirelessly to ensure justice and fair compensation for victims of ESI errors and pain procedure malpractice. Contact us today to schedule a free consultation and learn how we can assist you.



    Case Study: Spinal Cord Injury

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