Failure to Order X-Rays in the ER Shows Severity of Medical Malpractice
Dec 21, 2011
By Kerrie Spencer, staff writer – December 21, 2011
When someone has been in an accident, serious enough to be taken to the nearest medical facility, one would expect the attending ER doctor to deal with the manner expeditiously, professionally and accurately. That did not happen in this disturbing $9 million medical malpractice case.    What happened next was unbelievable.
This reported case took place in Cheyenne, Wyo., and resulted in one of the highest medical malpractice verdicts ever seen in the state. The existing record until this case was $1.5 million.  The verdict was for the plaintiffs. The jury found that the board certified emergency physician, working for the regional hospital where plaintiff Louis Prager was not treated properly, had egregiously and negligently breached the accepted standards of medical care.
Defendant Doctor Cullison failed to diagnose 51-year-old Louis Prager’s broken neck, which ultimately resulted in him not being able to work, caused permanent left shoulder paralysis and excruciating, debilitating, ongoing pain. The man’s whole life had been turned inside out by the medical mistreatment he received in the hospital. While the jury deliberated, they also concluded that the hospital and the doctor had seriously harmed Prager’s 30-year marriage, and awarded loss of consortium damages to the wife.
What happened to start this cascading chain of devastation? In December 2008, Prager was working in the oil fields, and was involved in a truck rollover accident. His truck slid off an icy road and rolled several times landing upside down.  EMS crews rushed to the scene, immobilized him using a backboard and put on a neck brace. These were all correct procedures for rollover accidents, and protected the neck and prevented any further damages. He arrived at the hospital with the neck brace in place and was seen by Dr. Cullison who released him from the ER without taking x-rays of the man’s neck or doing any type of physical exam.
This oversight was considered to be strange by the jury, as Prager quite clearly stated that his neck hurt and that he was in pain. The doctor did order x-rays of Prager’s head and back, but not his neck. However, he thought his neck had been done while the other x-rays were being taken or while he had been in the CT machine. They were not. To compound this evident lack of medical care, the doctor further assured Prager that he had no broken bones and that things appeared to be just fine.
They were hardly fine, as Prager had to go back to the hospital several days later and was then diagnosed with numerous cervical spine fractures, a paralyzed left arm and shoulder, and needed emergency neck fusion surgery. The final diagnosis of this set of medical events was that Prager now had permanent C5 nerve root damage, and is mostly confined to his house due to pain and disability. While the first surgery stopped further injury, it could not undo his nerve damage. 
The first neck fusion surgery was not the only one. He had to have a second operation (neck fusion) and faces additional surgeries in the future, including the implantation of a spinal cord stimulator with the aim of decreasing his unbearable pain levels. Prager’s injuries permanently altered the remainder of his life and the remaining years in his marriage. In other words, his injuries are classified as catastrophic.
Catastrophic injuries change an individual’s life, and quite often are the result of a sudden accident. These injuries have long-term consequences, some of which do not show up until later in life. The injuries are often permanent, with no hope of ever being in the condition they were in prior to their accident. Most victims with catastrophic injuries are not able to work again, and thus the only way they are able to care for themselves is to file a personal injury lawsuit to recover damages. 
It is common to expect that catastrophic injuries end up damaging the central nervous system, which then affects other organs and body systems. Spinal cord injuries, such as the one in this case, are very complex and victims most likely will need long-term medical care. They do not just deal with physical pain; they also face emotional and financial challenges on a daily basis that impact their wellbeing.
At trial, the defense denied that the doctor failed to do a physical exam of Prager’s neck and also said that people involved in a rollover should have neck x-rays. This was a clear denial from the defense, as the plaintiff could clearly recall whether or not he had a physical exam on the day of his accident. Despite being in shock, some things are remembered with startling clarity when one is in pain.
Additionally, the contention that it is not necessary to give a rollover victim a neck x-ray just defies conventional medical wisdom. The jury evidently felt the same way, or they would not have awarded the plaintiff $9 million; $7 million for the negligence of the hospital and the doctor and $2 million for loss of consortium.
Of note in this case is the interesting twist that developed at trial. The defendant’s own medical expert witness indicated that if Cullison had taken the time to do a physical exam of the plaintiff’s neck, the man’s spinal nerves would have made an examination difficult. It is rather counterintuitive to have a medical expert testify for the defense, and inadvertently help the plaintiff’s arguments.
Individuals place an enormous amount of faith and trust in doctors, especially when going to the hospital for emergency medical care. What a doctor says and does determines the outcome. If a doctor, or another medical professional does something wrong, or does not do something they should, the results can change a person’s life forever. Not for one minute should a doctor be allowed to get away with medical negligence. If that happens, it does not stop, and there will be other victims.
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