0:00

This was a patient with back pain.

0:02

Uh, patient was in severe pain.

0:05

The interventionalist looked at this.

0:08

They saw some, uh, disc hyperintensity

0:12

infection cross their mind,

0:13

but the patient was in severe pain.

0:15

The team was really pushing it, so they said, okay,

0:18

we will take care of it.

0:19

And they ended up putting cement in there.

0:21

But two or three days later,

0:23

infection was all over the place.

0:25

Now you can see abscesses, uh, formed in the, in the,

0:28

in the interlateral paraspinal space.

0:31

There is retropulsion

0:32

and the patient ended up having surgery

0:35

and sepsis and all that.

0:36

So, so never ever do this when you are even suspicious

0:40

of having, uh, infection in the spine.

0:43

You do not want to put anything, uh, uh,

0:47

into the spine at that point.

0:50

This was very, very unfortunate patient

0:52

that I was involved in.

0:53

So this was a compression fracture.

0:56

Patient was taken for vertebroplasty

0:58

kyphoplasty Procedure was done.

1:00

Patient was not moving the legs, uh, in,

1:03

in PACU right after the procedure.

1:05

And, and you can see this, this was a CT that was obtained

1:09

after, you can see that it's sort of going through

1:12

the lamina, which is now broken.

1:14

They went in through the parle

1:16

and they transected the spinal cord.

1:18

And you can see a complete transection of the spinal cord.

1:21

So obviously indefensible seizure error.

1:25

This is what's called gross negligence.

1:28

Uh uh, unfortunately unfortunate for the patient.

Case: Expert Witness - Osteomyelitis After Vertebroplasty with Epidural Retropulsion

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0:00

This was a patient with back pain.

0:02

Uh, patient was in severe pain.

0:05

The interventionalist looked at this.

0:08

They saw some, uh, disc hyperintensity

0:12

infection cross their mind,

0:13

but the patient was in severe pain.

0:15

The team was really pushing it, so they said, okay,

0:18

we will take care of it.

0:19

And they ended up putting cement in there.

0:21

But two or three days later,

0:23

infection was all over the place.

0:25

Now you can see abscesses, uh, formed in the, in the,

0:28

in the interlateral paraspinal space.

0:31

There is retropulsion

0:32

and the patient ended up having surgery

0:35

and sepsis and all that.

0:36

So, so never ever do this when you are even suspicious

0:40

of having, uh, infection in the spine.

0:43

You do not want to put anything, uh, uh,

0:47

into the spine at that point.

0:50

This was very, very unfortunate patient

0:52

that I was involved in.

0:53

So this was a compression fracture.

0:56

Patient was taken for vertebroplasty

0:58

kyphoplasty Procedure was done.

1:00

Patient was not moving the legs, uh, in,

1:03

in PACU right after the procedure.

1:05

And, and you can see this, this was a CT that was obtained

1:09

after, you can see that it's sort of going through

1:12

the lamina, which is now broken.

1:14

They went in through the parle

1:16

and they transected the spinal cord.

1:18

And you can see a complete transection of the spinal cord.

1:21

So obviously indefensible seizure error.

1:25

This is what's called gross negligence.

1:28

Uh uh, unfortunately unfortunate for the patient.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Majid Aziz Khan, MD, MBBS

Director, Non-Vascular Spine Intervention

Johns Hopkins University

Mahla Radmard, MD

Postdoctoral Research Fellow

Johns Hopkins University School of Medicine

Kelly P. Yousem, JD

Plaintiff’s Attorney

Lesson

Expert Witness Best Practices - Radiologist's Perspective

Lesson

Expert Witness Best Practices - Lawyer's Perspective

Lesson

Expert Witness Case Review - Introduction

Lesson

Expert Witness Case Review - Detection Misses

Lesson

Expert Witness Case Review - Communication Errors

Lesson

Expert Witness Case Review - Interventional Radiology

Lesson

Impact of Malpractice Litigation and Liability Considerations

Lesson

Expert Witness Case Review - Conclusion

Case: Expert Witness - Osteomyelitis After Vertebroplasty with Epidural Retropulsion