A patient with a complex history of cervical spine surgeries, including multiple neck fusions, suffered a severe, permanent spinal cord injury and nerve damage following a Cervical Epidural Steroid Injection (CESI)—an injection of anti-inflammatory medication into the space surrounding the spinal cord to relieve pain. Despite the patient’s elevated risk profile from past operations, the procedure was performed above the recommended anatomical levels. During the injection under conscious sedation, CSF (cerebrospinal fluid—the protective liquid surrounding the brain and spinal cord) was observed, indicating a dural puncture or “wet tap” where the protective spinal membrane is accidentally pierced. The procedure resulted in an incomplete spinal cord injury, extensive denervation (loss of nerve supply causing muscle weakness and paralysis), and the development of a syrinx (a fluid-filled cyst within the spinal cord that damages nerve fibers). Representation was provided to hold the pain management practitioner accountable before the Louisiana Patients’ Compensation Fund https://www.doa.la.gov/doa/mmc/pcf//.
Case Profile
The Claimant: A long-term pain management patient with an extensive cervical surgical history, including a C4–5 laminectomy/foraminotomy (surgery to remove part of the vertebra and enlarge the spinal canal to relieve pressure) with posterior lateral fusion, and prior anterior cervical discectomies and arthrodesis (surgical joint fusions) at C5–6 and C6–7.
The Defendant: A pain management physician operating at a Lafayette, Louisiana specialty surgical facility.
Incident Dynamics: The physician attempted a CESI at the C3–4 level—above prior surgical fusions—using a 20-gauge Touhy needle. After encountering cerebrospinal fluid (a “wet tap”), the physician redirected the needle below the fusion without providing an adequate warning of the significantly heightened risk of nerve injury caused by the patient’s existing altered anatomical structures.
Injuries & Medical Taxonomy
- Incomplete Spinal Cord Injury: Partial damage to the spinal cord that impairs sensory and motor signaling while leaving some pathways intact.
- Cervical Myelopathy: Severe spinal cord compression or injury in the neck leading to weakness, numbness, and motor dysfunction.
- Syrinx: A fluid-filled cavity/cyst within the spinal cord that expands and compresses vital nerve fibers.
- Denervation & Anterior Horn Cell Loss: Loss of nerve signaling to muscles, resulting in weakness, atrophy, and loss of arm function.
- Left Hemi-Spinal Cord Lesion: A localized area of damaged tissue on the left side of the spinal cord affecting sensation and motor control.
Jurisdictional Basis: Medical malpractice panel proceedings under the Louisiana Patients’ Compensation Fund https://www.doa.la.gov/doa/mmc/pcf/ (PCF No. 2013-00741).
Regulatory Breaches & Standard of Care Violations
1. Failure to Inform of Increased Complication Risk: Performing high-risk interventional spine procedures on patients with extensive prior cervical fusion hardware requires explicit, tailored disclosure of the heightened probability of permanent neurological injury beyond standard boilerplate consent forms.
2. Inappropriate Anatomic Selection: Attempting a cervical epidural steroid injection above C7 in a patient with a compromised, altered spinal architecture presents an unacceptable risk profile under established interventional pain management guidelines.
3. Improper Needle Technique Leading to Direct Cord Trauma: Piercing the dura mater (the protective outer layer of the spinal cord) and introducing foreign matter or trauma directly into the cervical cord tissue constitutes a departure from the accepted standard of medical care.
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If you or a family member suffered severe nerve damage or spinal cord injury following a cervical spine injection or medical procedure, contact Kenneth D. St. Pé for a confidential case evaluation.
Kenneth D. St. Pé, APLC
311 West University Avenue, Suite A
Lafayette, Louisiana 70506