Epidural Steroid Injections caused Spinal Meningitis

On Monday last week my husband had  the 1st of 3 Epidural Steroid Injections to his Cervical Spine. Immediately after the injection he started having SEVERE headaches and nausea. The Dr. sent him home to lay down.

Tuesday we had to go back for a Blood Patch, due to getting a Dural Puncture.  Wednesday morning he awakes to yet another headache, however not as severe and a stiff neck.  Nausea and vomiting follow in the early afternoon. By 4:30p he is running a High Fever 102.4 and uncontrollable Headache. I called Dr.s office and was sent immediately to ER.

Admitted to the Hospital after running a lumbar puncture and confirming a Spinal Meningitis. By Saturday the culture had grown showing Stepococcual Meningitis(Bacterial).... The Infectious Disease Dr told us that however preventable, he contracted this and numerous other complications from the Steroid Injections.

Now my husband is back at home after 7 days in the Hospital and will be on Intravenious antibiotics through a PICC line for the next 3 to 6 weeks.  The Dr who did the Injections never discussed this as a complication. We even have a phamplet and a release that my husband had to sign, this was Never discussed. The Dr even came into the hospital and said he has no clue how he contracted Meningitis but to Re-Schedule the additional Injections for after the Antibiotic Stint(Yeah right, not after 2 mess ups.)

I have been looking for an attorney in our area since Monday, but none have returned our calls or emails.   Are we taking this overboard because this is such a Rare complication?

A check of the literature does not list meningitis as a side effect of spinal epidural injection, although several other possible complications are listed including a reaction to certain medications or medical treatments. 

Bad outcome does not necessarily mean malpractice occurred and there are always a small number of people who might unavoidably react adversely to a medication/treatment.

Fortunately, it appears from your post that your husband will recover.  In order to sue for medical malpractice, in addition to proving negligence occurred, damages must be significant in order to recoup the high costs of pursuing this type of litigation.

We can only suggest you discuss with a medical malpractice attorney in your state.  If he believes malpractice might have occurred, he will arrange for your medical records to be reviewed by an expert.  It is also possible--if an attorney reviews a case which he believes is not strong, the plaintiff may have to pay for initial medical review, which can cost several thousand dollars.

I would suggest your husband consult with other specialists before repeating the procedure.

it is highly unlikely the injection actually CAUSED the meningitis. The injection site may have allowed the bacteria to get in - but that is not a malpractice issue.

As someone who works in the neurology/neurosurgery field spinal meningitis is not a known complication of epidural steroid injections.  It is entirely possible that this is a rare coincidence that your husband developed this infection at the same time he had the injections. 

As Carol said only a review by a malpractice attorney can determine this.  The reason attorneys in your area have not returned the call is that they may be precluded from being involved due to a conflict of interest.  You may need to go outside your local area.  Try calling outside the area for a phone consult.  Those are free.  They may ask you to send copies of his preliminary records for an initial review.

Backing up what Carol said the high cost of litigating these cases also means that if there are no permanent damages and a cause/effect relationship cannot be established between the injections and the infection with a negligence factor then no attorney is going to proceed. 

Thankfully your husband is doing better.

Thank you for all your responses.  We have actually been speaking to the Infectious Disease Center, they are the ones currently treating my husband for the Spinal Meningitis.  They have advised that he did infact contract the Bacterial Meningitis due to a puncture to his Spinal Fluid and the bacterial being injected as well as his own blood.

The Infectious Disease doctor&nb... explain that this is a Very Rare side effect/ complicat... I as well have done some serious research and found these very informative websites

http://www.e-steroid.c...

   http://www.springerlin...

I'm so sorry this happened to your husband.  I hope he is OK now?

Unfortunately, I've had a similar situation and we're starting to seek legal advice as well.  Have you had any luck finding someone to help you?

"this is a Very Rare side effect/ complicat"

In which case it is not likely to be malpractice.

I got bacterial meningitis from a steroid shot too. 13 hours after the shot I got a severe headach and about 10 mins later I was very ill. Called ambulance and was rushed to the hospital. Ended up intibated in a drug induced coma for 12 days. Was in the hospital for a month. Took awhile for me to gain my strength back and see and hear better. I was not sick prior to the shot. It was my third shot. First 2 shots no problem. Third one hurt more and I was sick when I left the office. I was told my infection was not staff but respitiory. I was also asked if the registered nurse who did the procedure wore a mask. Finding an attorney has been difficult with the new malpractice laws. If I had died I'm sure my children would have not had a problem. I was unable to work for 9 months..Had to file bankruptcy and although the docs say I will make a full recovery I disagee. I will never be the same. Muscle loss, memory problems, severe fatigue and headaches. This is such a rare complication that the hospital was going to send me home. Doctor said if they had I would have been dead in an hour. Children were told I might not make it 24 hours. Then when it looked like I was going to make it they were told I could have brain damage. Medical bills are high and I do not understand why it is so hard to find an attorney. I have also been contacted by 2 others who had shots by the same person and had complications. None as serious as mine. One went to the same hospital and they immediately ran tests because my case was fresh in their minds.I would feel terrible if someone ended up losing their  life by someone who is not qualified to do the shots or is negligent.My shots were not done by a doctor they were by a CRNA...certified registered nurse anesthetic. They can do the shots in my state but doctors I have spoke to do not feel they are qualified. I was referred by the place that was doing my therapy. Had I known what I know now I would have went to a sterile medical facility with a doctor who performed the procedure.I found your story and wanted to tell you mine.  I hope your everything goes well for your husband. It is a very scary thing to go through. My children were so upset and scared for me. I hate they had to see me like that and had to go through the pain they suffered.

Well -- I too just returned from the emergency room where I was diagnosed with aseptic miningitis, most likely the result of an epidural block (pain treatment) that was performed on my back last Wednesday. I became symptomatic (head aches) on Friday with admission to the ER by noon Sunday.  ER Dr's quickly ruled out bac/viral infections but would not conclusively state with 100% certainty that the aseptic was totally accurate. When I pressed for a more informed diagnosis, they stated there were three possibilities for my infection: (1) Bacterial (ruled out), (2) Viral (ruled out), (3) Aseptic as a result of an introduction of the infection into my spine (no conclusive statement).  In other words very non-commital by the ER Dr's.  Sorry to hear of so much suffering and pain out there because of this type of treatment. I guess my idea for recovering my lost wages isn't going to happen. I assume there may be a way to at least file a complaint against the dr who drilled the infection into my back?

I am so sorry to hear about your problems.  I can certainly feel for your family, it has been a very rough process.  We have now been to more doctors than we can count, and certainly more than ever expected through Workers Compensation.  My husband will no be receiving any additional Injections, the chances of it happening again are far too high for us nor his Primary care Doctor to chance.  The Legal department with the Division of Workers Comp in TX is actually running an investigation to verify some of the questions of the Dr who performed the procedures, maybe that will go somewhere.  Maybe not, at this point I am happy to know that my husband is still alive.  We have not found an attorney, our problem is one that is willing to fight with a Workers Compensation Claim.  We have several that would be willing to persue the Meningitis issue, however we will have to wait for the outcome of the WC claim first.  I could not begin to understand the medical charges and how to pay them if it was out of pocket, I hope things work out for you.  You are in my heart, I can feel your pain

My husband is actually scheduled for an Anterior Cervial Disectomy w/ a Spinal Fusion on December the 9th of this year.  Hopefully all will go well.  FYI this is another Dr, and seems to be a very knowledgeable one as well.  Knows and accepts the Spinal Meningitis, and is very cautious of preventing it.

I am also sorry to hear about your case.  This seemed to have boggled several of the ER and hospital staff until the blood work and other procedures came back in.  We have seen more Doctors since August when this happened than I think I have ever seen at a Hospital period.  My husband is doing much better, after 4 weeks of IV antibiotics from the Infectious Disease Center.  He will not be going in for additional Injections do to the increase risk of contracting this again.  We have changed our view to a surgical standpoint.  He will undergo a Anterior Cervical Disectomy with Spinal Fusion on December 9th.  The Workers Compensation Legal Dept is also investigating the Dr who performed the original procedures.  Maybe they will have better luck than us.  We have found several Attorneys willing to accept our case however, we are dealing with Workers Comp, so we must wait until his claim is closed.  We will be fighting this to the end, once my husband is off the claim.  Good luck to you, and I hope you recover well.

I sincerely hope your husband is going to be OK, but when he does go in for the operation be careful of what you sign off on.  Myself I had 1 injection and had a very bad almost allergic reaction to it as soon as the pain meds was lowering in my system i.e. trouble swallowing rapid heart rate feeling llike my tounge was swelling hard time breathing etc.  My friend wanted to take me to the hospital but I said no, I cannot stand ER's, instead I went home and it took most of the day to recover.  Eventually when I saw the doctor next and told him of the reaction we had decided to operate after thinking about things I forgot 10 yrs prior I had been given presidone for a throat operation and had simular sid effects so we had to go the route of surgery.

Before the surgery I had told the doctor and anastegiologist that I was allergic to steroids, it was even marked down on one of the paper copies they gave me to sign and almost at the end of the surgery he used Depo-Medroll in the epidural space where they had the camera while performing  the l3/l4 and l/5 lamenectomy and partial discetomy due to inflamation.  He used this substance that is a steroid on freshly open op site onto my awaiting nearves and closed.  A few days @2-3 I developed a severe headache and was emitting fluid from the op site by the hand towel fullly soaked so I had to go back to ER and be admmitted to hosp.and latter3 days they finally operated, in the report they put down that the fluid was clear but it was pink because my friend had to wash it for me and it was definately had blood mixed down with it.

This was in 08 and now the doctor dumped me at least 9 mos. ago said he do nothing more for my pain, which had by then increased 100% not to mention lost of use of walking for more than a few feet, incontance issures etc. I sought a 2nd opion from a neurosurgeon whom ran a seriea of test including an MRI w and w/o contrast, a spect scan, and an xray of my spine bending forward and backward (my neck was killing me even at the beginning of this nightmare and the 1st dr. did and mri of it) that was in sept. of 08 was diagnoised with Adheasive Arachnoiditis, Epidural Fibrosis, Stenosis of both the lumbar and cervical over 4 vertabrae's, Failed lamenectomy syndrome, Spondilosis and I am now having problem with Neuropathy in my hands and especially feet.

Just make sure they do not use Depo-Medrol on your husbandl, my friend said that after seening my become a partial parapaligic there is no way he will have surgery done on his back befor my operation he needed 2 disc's replaced. I have read a lot on this subject and most people whom contract menningitis after epidural treatment and even while having a baby they used Depo-Medrol within the injection sight.  Now the manufactures state they do not recommend the use for it to be used directly on exposed nearves but the doctors keep using it, why?

I am a 48 yr old woman that cannot even pick up here grandchildren, play with them ha that's a joke, I just keep detiorating at a very fast pace and with no insurance, but I cannot finx 1 lawyer in the area I live in to sue this doctor or anyone in the op room whom should have looked at the chart that said I had an allergy to steroids.  I don't know if they think it is just to one but there was a reation to 2 different ones, it doesn't take a rocket scientist to think there may be more steroids she's alleric to?

I think your right on target with your thinking about contacting an attorney, Sorry to hear none have replied to your calls. May I suggest an attorney that may be of great assistance to you? Please reply to my email address if you would like further discussion.

I will look for your email. However to make it a bit easier to find among the many I receive please add the following to the subject line: Help Spinal Meningitis

Sincerely, 

William E. Hilson     &nbs... hilson@okstate.edu  

I can pretty much assure you 100% that the infection was caused due to contamination during the blood patch.  I have personally placed a few dozen of these and can tell you that unless absolute meticulous sterile technique is followed there is a high likelyhood that you will wind up with skin bacteria being injected into the epidural space along with a nice 30ml's of blood for it to grow in.  Most pain docs were at some point in their life practicing anesthesiologists so they tend to be very careful to avoid contamination, that said I have witnesses quite a few that are just plain sloppy, doing things such as drawing blood out of an existing IV for the patch or simply swabbing the skin with alcohol prior to drawing the blood.  What you need to do is sit down and write down every single detail about the procedure that you recall in order to best determine if any standards of care were violated.  Chances are that somewhere in your husbands medical record is a consent he signed that states "risks were discussed" so that argument will basically get you nowhere.

You also need to be prepared for the fact that despite your husbands ordeal no actually negligence occured and this was just plain bad luck.

My infection wasn't a staff infection...it was respititory. From my understanding that is rare and is caused by coughing or sneezing around the needles.Meningococcal Pneumonia got into my spinal cord. I was told the worst thing that could happen verbally by the woman was a horrible headache. I did sign a consent form but nothing on there said I could get this almost die or my children to be told she is going to pull thru but might be death, blind or brain damaged. If these are the ligitimate risks I feel the shots are not worth it! There are other things to help with back pain. I can live with the pain but what I went thru was not worth it! I still have back problems foot has been numb almost 2 years. Having meningitis made everything worse and now I have permanent damage.I feel some are doing those shots and are not qualified! Mine was done by a registered nurse anesthesiologist. I have found out since this person has hurt others. No one as bad as me as far as I know. I guess its just a matter of time.