The erythrocyte sedimentation rate: an interface between science and the law

Excerpts from the deposition of a medical expert appearing for a female plaintiff in a malpractice action dealing with a postoperative disk space infection are presented. Much of the issue centered about the erythrocyte sedimentation (ESR) rate 4 months postdisk surgery (ESR = 23 mm/hr). The expert testified that the ESR will, after an initial rise, return to normal levels in the face of progressive symptomatology and inflammatory bone change. The pertinent literature cited indicates that the elevated sedimentation rate in infection not only persists, but escalates and remains in an elevated state until appropriate therapy is instituted.