Document Detail


Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.
MedLine Citation:
PMID:  23276337     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
EDUCATIONAL OBJECTIVESAs a result of reading this article, physicians should be able to:1.Diagnose spinal epidural hematoma and spinal epidural abscess.2.Outline the most common neurological deficits that occur from a spinal epidural hematoma or spinal epidural abscess.3.Identify indications for a good or poor prognosis.4.Minimize adverse outcomes for the provider. Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider.The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control.All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.
Authors:
Keisha L French; Eldra W Daniels; Uri M Ahn; Nicholas U Ahn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  36     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  48-53     Citation Subset:  IM    
Copyright Information:
Copyright 2013, SLACK Incorporated.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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