A judge sided with the defense in a malpractice suit filed against several Indiana physicians and treatment groups by a patient who alleged that misdiagnosed lower back pain and a misguided epidural injection led to paraplegia.

According to court records, the patient, Cynthia Gustafson, consulted with John Lomas, MD, at the Center for Orthopaedic Surgery and Sports Medicine in Indianapolis in April 2004 complaining of chronic pain in the lower back and both legs. While a physical exam indicated no compromised motor function, the patient argued that an MRI scan was inconsistent with the clinical findings.

Dr. Lomas recommended an epidural steroid injection at L5-S1, and referred the patient to Roberto Patron, MD, at the Indiana Surgery Center South in Indianapolis. Dr. Patron administered an epidural steroid injection at L3-L4.

In her lawsuit, the patient cited several irregularities during this procedure, including no electronic monitoring of vital signs and no administration of intravenous fluids. She claimed that the needle made contact with her spinal cord, as she felt a tingling in her legs, which she was suddenly unable to move, and a headache. Responding to her complaints, Dr. Patron injected a dose of steroids into the spine. Once Ms. Gustafson was able to move her legs, she was released.

A month later the patient presented at Community Hospital South in Indianapolis complaining of pain in her right leg. She was transferred across town to Methodist Hospital of Indiana, where she was under the care of physicians from three treatment centers.

At Methodist, Ms. Gustafson alleged, she progressed to full and permanent paraplegia due to an epidural or spinal abscess compressing her spinal cord. Her lawsuit argued that this could have been avoided with a prompt and proper diagnosis, drainage and antibiotic treatment. She blamed each physician and treatment center involved in the case for their failure to meet the standard of care.

A judge dismissed the claims against each defendant, except for those against Dr. Patron, who administered the injection, and Indiana Surgery Center South. Those claims proceeded to a jury trial in April 2011. At the center's request, the judge issued a directed verdict that the patient's case against it was inadequate. The jury later ruled in favor of Dr. Patron.

Robert Murphy