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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
Published on: November 3, 2016
[Incomplete paraplegia after delayed diagnostics of motor function deficits. Severe malpractice?]
1Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie, Campus Innenstadt, Klinikum der LMU München, Nußbaumstraße 20, 80336 München. markus.regauer@med.uni-muenchen.de
Der Unfallchirurg
|March 13, 2013
Summary
Delayed diagnosis of a thoracic vertebral fracture led to permanent paraplegia in a patient initially treated for a femoral fracture. Prompt investigation of neurological deficits is crucial for timely intervention and potentially better outcomes.
Area of Science:
- Medical malpractice
- Neurosurgery
- Orthopedic surgery
Background:
- A 72-year-old female with a subtrochanteric femoral fracture underwent surgical stabilization.
- Following transfer to a rehabilitation center, the patient developed new-onset lower extremity motor deficits and paraplegia.
Observation:
- Neurological symptoms appeared 5 days post-transfer, with paraplegia diagnosed the next day.
- Magnetic resonance imaging (MRI) revealed a suspected unstable seventh thoracic vertebral fracture 8 days after symptom onset.
- Computed tomography (CT) confirmed the fracture, followed by surgical decompression and stabilization 4 days later.
Findings:
- Incomplete paraplegia persisted permanently despite surgical intervention.
- Expert opinion and arbitration board findings indicated delayed diagnosis and treatment of the vertebral fracture constituted medical malpractice.
- While emergent treatment's impact on outcome is debated, evidence suggests it could have potentially prevented permanent paraplegia.
Implications:
- Highlights the critical importance of immediate investigation of new neurological deficits in rehabilitation settings.
- Underscores the potential for severe, permanent consequences due to diagnostic delays in spinal injuries.
- Emphasizes the legal and ethical obligations for timely medical assessment and intervention to prevent avoidable patient harm.
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