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Mis Diagnosis of Epidural Abscess Leads to Paralysis

Sheila Matthews, a Naples mother of three, walked into NCH North Naples Hospital’s emergency room in March 2005 in extreme pain.

Over the years, the 55-year-old retired nurse had suffered from diabetes, peripheral neuropathy and bipolar disorder. On a scale of one to 10, she told doctors, this was a nine. The pain grew as doctors tried to determine what was wrong.

“She’s screaming, she’s in so much pain,” Matthews’ attorney, Nancy La Vista of West Palm Beach, told a Collier Circuit Court jury during opening statements Aug. 13.

Six days later, Matthews would become a quadriplegic.

Most doctors wouldn’t want a woman reclining in a gurney, covered in blankets, testifying about her painful ordeal. And these doctors were blaming the care at NCH North Naples Hospital, which settled the first day of jury selection for a confidential amount.

That left three Naples doctors, Sunil Pandya, an internist; neurologist Michael Vickers; and Daniel Singer, a radiologist, as defendants.

The trial is in its second week of testimony, after a jury was picked in three days. Over the first six days of testimony, jurors heard videotaped depositions, including Pandya’s, and testimony from medical experts who have been cross-examined by each doctor’s defense attorney.

“How did he handle the fact that at 3:20 in the morning, despite all those medications, Sheila Matthews is screaming in pain?” La Vista asked her internal medical expert, Dr. Walter Kernan, last week, referring to Pandya.

Kernan would later tell jurors: “If someone had tried to get her out to walk, that would have eliminated all uncertainties about her diagnosis.”
It’s a rare diagnosis, an epidural abscess, and the experts and doctors have told jurors they’ve only seen a handful.

Kernan told jurors they can form over a long period — or over hours, days, weeks or months. “But most acute epidural abscesses develop over hours and days most typically,” Kernan testified. “As an internist, I think it was there for a matter of days.”
Kernan’s opinion was that Matthews’ diagnosis was delayed due to negligence.

Matthews’ 2007 medical malpractice lawsuit alleges she suffered from progressive neurological deterioration after she was admitted March 29, 2005. Six days later, she was transported to NCH Downtown Naples Hospital for a lumbar magnetic resonance imaging (MRI). Two days later, another MRI found a large epidural abscess on her spine.

A neurological consult was immediately requested and decompressive surgery was performed to remove it. But it was too late: Matthews had suffered severe, permanent neurological dysfunction.

Among the lawsuit’s allegations are that the defendants were negligent for failing to perform proper nursing assessments; not notifying doctors of significant changes in her condition; failing to perform timely MRIs; not documenting nursing assessments; not admitting her into the intensive care unit for close monitoring; and failing to identify and recognize Matthews’ progressive neurological condition.

The lawsuit alleges defendants didn’t follow Vickers’ orders to perform cervical and thoracic MRIs. If the lumbar MRI was interpreted as normal, Vickers wanted the other MRIs to rule out a bacterial abscess.

Matthews has Medicare and was a licensed practical nurse in Naples who hadn’t worked since 1992 due to a work injury that caused leg pain, reflex problems and numbness.

If she wins a large award, she will temporarily lose Medicare and have to pay the full price of medical bills until the money runs out and she again becomes eligible.

Jurors have heard all Matthews’ ailments in the hospital and her past medical history dissected by attorneys. They’ve heard that two nurses didn’t fully enter Vickers’ orders into the hospital computer. That meant other doctors didn’t know he’d recommended two more tests to rule out a bacterial abscess.

They’ve heard how Matthews’ condition declined, how there was numbness, weakness and eventually she couldn’t walk.

In her opening statement, La Vista told jurors Matthews had medical problems, but could drive, shop, climb stairs — everything most people do.

She told jurors Matthews entered the hospital complaining of shortness of breath, a fever and pain, and doctors tried to rule out bronchitis, pneumonia and other diagnoses.

La Vista also told jurors she was retaining a large amount of urine, the amount in a liter of Pepsi, which should have concerned doctors because she’d never had bladder problems. After three days, nurses told Pandya she had weakness in her legs and arms, so Pandya consulted with Vickers. Six hours later, Vickers checked Matthews, who couldn’t or wouldn’t sit up.

“So what he decides is maybe she has a spinal infection,” La Vista said. “Dr. Vickers, despite his note that it would be urgent, does not choose to do a stat MRI.”
The next day, her fifth, Matthews’ fever ranged from 99 to 104 degrees and she was taken to NCH Downtown Naples Hospital for the lumbar MRI, which showed a herniated disk. But the other MRIs Vickers recommended weren’t done, La Vista said. He questioned why when he saw that a day later, wrote another order but it also wasn’t given stat priority.

“By this time, Sheila Matthews … is paralyzed in her arms and legs,” La Vista said, adding that when Vickers saw the MRIs, he called Singer to say it was an epidural abscess.

“Now it is an emergency and everything started to move,” La Vista said, adding that neurosurgeon Dr. Paul Dernbach was called in for surgery. “Fortunately, she did regain some function.”
But, La Vista told jurors, “She’ll never have control of her bladder, her bowels — and she’ll never walk.”
If you or a family member has been injured because of the fault of someone else; by negligence, personal injury, slip and fall, car accident, medical malpractice, trucking accident, drunk driving, dangerous drugs, bad product, toxic injury etc then please contact the Fort Worth Texas Medical Malpractice Attorney Dr. Shezad Malik. For a no obligation, free case analysis, please call 817-255-4001 or Contact Me Online.

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