Yasmin Valdez came to ORMC’s Emergency Department complaining of back pain on January 8, 2013. She was seen by Dr. Robert Simmons. An MRI showed a large disk extrusion at L3/4 and a broad-based disk bulge with central disk protrusion at L4/5, with severe stenosis of the central canal at both levels. After examination by Dr. Simmons, Yasmin was discharged with instructions to follow up the next day with neurosurgeon Dennis Winters, M.D.
After discharge, her symptoms worsened and by the morning of January 10, she was paralyzed and had lost bladder and bowel function. She saw Dr. Winters in his office that day and returned to ORMC. Emergency decompression surgery was performed for cauda equina syndrome. However, it was only partially successful: Yasmin has a continued foot drop and some urinary dysfunction; she wears ankle braces, sometimes uses a cane, and intermittently self-catheterizes.
-Yasmin should never have been discharged from the ED. She could barely walk without assistance- that alone indicated a severe problems. In fact, she had all the indications of a developing cord compression, and a neurosurgeon should have been called in by Dr. Simmons.
-Had this been done, surgery would have been undertaken immediately, and Yasmin’s permanent disability would never have happened.
-Yasmin did call the neurosurgeon on the morning of the 9th, but was told that she could not be seen for several weeks. In any event, it doesn’t matter, as a neurosurgeon should have seen her in the ED, and the decision on whether she was emergent enough to immediately see a surgeon should not have been left to her.
-Dr. Simmons did a complete neurological examination and found no sensory or motor deficits, nor any bowel or bladder dysfunction. There was no indication of spinal canal impingement either by examination or by MRI.
-Yasmin was able to walk in the ED, and would not have been discharged if she couldn’t.
-Yasmin was told to followup the next day with the neurosurgeon. There weren’t enough symptoms to warrant calling Dr. Winters into the ED, but he did need to examine her soon to determine if the suspected disc herniation was worsening.
-Yasmin was instructed, in writing and verbally, to return to the ED immediately if her symptoms worsened. But she didn’t do anything until two days later, even though her symptoms were worsening.
-She was also told that if she had any difficulties getting in to see the neurosurgeon, Dr. Winters, she could call the ED and they would help arrange the appointment. Yasmin claims she called Dr. Winters on the morning of January 9, but her phone records do not support that claim.
-This trial should take about two weeks; there are many experts. I will update my blog as information becomes available.
-There were some interesting motions in limine on a variety of issues. Copies of the plaintiff’s Motion in Limine and Judge Bean’s Order on Pretrial Motions are linked. Plaintiffs’ counsel in medical malpractice cases are commonly filing these motions in limine to head off potential trial issues, just as defense counsel have been filing “Anti-Reptile” motions for several years.
-Ogden Regional Medical Center had been a defendant but settled before trial. (There will be an allocation-of-fault line on the special verdict form for it.)
-Damages claimed are past medicals of about $700,000, future lost wages of $1,600,000, and a life care plan in the range of $4,000,000.