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Failure to Order Thoracic MRI
July/August 2019Mitchell v. Kaiser Found. Health Plan, Inc., Cal., mandatory arb., Oct. 25, 2018.
After falling, John Mitchell, 53, went to a Kaiser Permanente occupational medicine specialist, complaining of back pain, numbness, and weakness. The physician prescribed steroids and a muscle relaxer and told Mitchell to return in one week. At the next appointment, Mitchell reported increased numbness and weakness in his legs. The doctor referred Mitchell to a Kaiser emergency room for an MRI of his lumbar spine. This test showed mild degenerative changes, and he was referred to a neurologist. Before that appointment, Mitchell met with a Kaiser physiatrist, who ordered a STAT MRI of the thoracic spine. The first available appointment was four days later. By that time, Mitchell could not walk without assistance. The MRI showed a herniated thoracic disk at T9-10 with spinal cord compression. Despite emergency decompression surgery and a laminectomy, Mitchell now suffers from incomplete paraplegia. Although he taught himself to walk again, he has an impaired gait and must use a cane and a wheelchair for long distances. Mitchell claimed that Kaiser Foundation Health Plan should have timely diagnosed possible spinal cord compression and performed the STAT MRI. Mitchell claimed more than $31,500 in lost earnings. The defense argued that Mitchell’s injuries could not have been avoided. The arbitrator awarded more than $3.47 million.
Claimant counsel: AAJ member Robert F. Vaage and Elizabeth Teixeira, both of San Diego.
Claimant’s experts: Amy Magnusson, physical medicine, Ned Chambers, primary care, and Michael Nakada, economics, all of San Diego; Todd Moldawer, orthopedic surgery, Van Nuys, Calif.; Carol Hyland, life care planning, Lafayette, Calif.; and Kenneth Corre, emergency medicine, Los Angeles.
Defense experts: Brian Belnap, physical medicine, Encinitas, Calif.; Brian Brinig, economics, and Howard Tung, neurosurgery, both of San Diego; Alicia Benjamin, internal medicine, La Jolla, Calif.; Michael Forman, emergency medicine, Oceanside, Calif.; Michael Lobatz, neurology, Carlsbad, Calif.; and Reginald Gibbs, life care planning, Billings, Mont.