More than 18,000 Americans suffer a traumatic spinal cord injury (SCI), caused by a sudden external event such as work injuries, motor vehicle accidents, or sports injuries, each year. Of those SCIs, fewer than 5% result from medical or surgical procedures.
That percentage does not include diagnostic errors, however; given that delayed or incorrect diagnoses are among the five most common medical errors, it’s safe to assume that they are responsible for an additional percentage. And let’s not forget that non-traumatic SCIs, due to infections, tumors, degenerative conditions, and other internal causes; these are estimated to account for almost a third of all new SCIs each year, or more than 7,000 cases.
The myriad types and causes of SCIs make the number of potential spinal cord injury claims difficult to estimate. What’s easier to pinpoint is the median spinal cord injury compensation: more than $1.6 million, according to Global Spine Journal; other reports put the sum even higher. That’s far above what varying studies estimate to be an average malpractice payout of $300,000–$450,000.
The average settlement for spinal cord injury is high by comparison largely because the effects of SCIs can be disastrous. Any resulting paraplegia, quadriplegia or tetraplegia, incontinence, or cognitive decline can not only curtail earning potential and cause substantial pain and suffering but also require costly long-term rehabilitation, daily professional care, and assistive technology.
Spinal cord injury awareness month is September, but below we’ll look at numerous aspects of spinal cord injury malpractice:
A spinal cord injury is damage to the cord itself, or the nerves, nerve fibers, or blood vessels that make up the column extending from the lower part of the brain down to the lower back. Nerve roots branch out from each section of the spinal cord to control movement and sensation throughout the body. If the SCI resulted from a healthcare professional’s failure to provide an accepted standard of care, the practitioner and facility could be open to a lawsuit for malpractice.
When evaluating a possible spinal cord injury, medical professionals check for loss of movement, sensation, or reflexes. Recognizing spinal cord injury symptoms early is crucial for prompt treatment and better outcomes.
There are two types of spinal cord injury: complete and incomplete. When the damage to the spinal cord is so significant that no signals from the brain can travel beyond the injury site, resulting in total loss of movement or feeling below the site, it is considered a complete SCI.
An incomplete spinal cord injury results from less severe damage; because some communication remains between the brain and the SCI site and the patient retains some feeling or functionality below the injury.
Healthcare professionals use the American Spinal Injury Association (ASIA) Impairment Scale to classify levels of spinal cord injury by how severely motor and sensory functionality are impacted. The injury's severity is a key factor in determining the classification and prognosis of spinal cord injuries.
SCIs are also categorized by the site of the injury. Damage high on the spinal cord affects more areas of the body than lower injuries do. The eight cervical nerves are in the neck, so damage to them could result in paralysis of all four limbs and make swallowing and unaided breathing impossible.
Injuries among the thoracic nerves of the upper back can affect the arms as well as the chest and below. Those with a lumbar or sacral spinal cord injury might retain functionality and feeling in the arms and chest but lack the same in part or the entirety of their legs as well as suffer from bladder, bowel, or sexual dysfunction.
Many SCIs are considered catastrophic, differentiating them from other types of injury. In legal terms, catastrophic injuries are long-term or permanent, significantly impair the ability to work or care for oneself, and require lifelong medical care, not only for the injury but also for secondary consequences, which can range from deep vein thrombosis to pressure sores to cardiovascular disease. A spinal cord injury is often classified as a serious injury due to its long-term impact.
These factors, which place an onerous financial burden on the spinal cord injury victims and their families, differentiate SCIs and spinal cord injury lawsuits. In addition to economic damages, non-economic damages, such as pain and suffering or loss of enjoyment of life, are also significant in spinal cord injury lawsuits.
Immediate medical treatment is critical for anyone who has suffered a spinal cord injury. The first priority for medical professionals is to prevent further injury and stabilize the spinal column, as any unnecessary movement can worsen spinal cord damage. Emergency responders and hospital staff will typically immobilize the head and neck to protect the injury site and minimize the risk of additional harm.
Upon arrival at the emergency room, a thorough medical evaluation is conducted to assess the severity and location of the cord injury. This includes checking for loss of movement, sensation, or reflexes below the injury site. Diagnostic imaging, such as X-rays, CT scans, and MRI scans, are essential to identify fractured vertebrae, dislocations, or other spinal column abnormalities. These tests help medical professionals determine the extent of spinal cord damage and guide the next steps in medical treatment.
Treatment for spinal cord injuries often involves a multidisciplinary team, including doctors, nurses, physical therapists, and occupational therapists. In many cases, immediate surgery may be necessary to relieve pressure on the spinal cord, stabilize fractured vertebrae, or repair damaged bones called vertebrae. Medications may be administered to reduce swelling, manage nerve pain, and control muscle spasms. For injuries that affect respiratory function, mechanical ventilation may be required to support breathing.
Physical and occupational therapy are vital components of the recovery process. Physical therapy focuses on improving muscle movement, strength, and coordination, while occupational therapy helps spinal cord injury victims adapt to daily activities despite physical limitations. These therapies aim to maximize independence and quality of life, helping the injured person regain as much function as possible.
Ongoing medical care is also essential to address complications that can arise from spinal cord injuries, such as urinary tract infections, pressure sores, and chronic pain. Regular check-ups allow medical professionals to monitor the patient’s progress, manage symptoms, and adjust treatment plans as needed to prevent further injury and promote recovery.
Access to immediate medical treatment and comprehensive rehabilitation, is essential for spinal cord injury victims. By understanding the importance of prompt care and ongoing management, individuals and their families can better navigate the challenges of recovery and work toward achieving the best possible outcome.
Among the more common types of medical malpractice we see related to SCI include:
Accidentally damaging nerves or the spinal cord during surgery, operating on the wrong body part, failing to adequately remove tissue or bone that is compressing the spine, failure to properly treat herniated discs or spinal fractures, neglecting to maintain proper blood flow to the spinal cord during surgery, and leaving foreign objects in the patient are among the surgical errors that could spur a spinal cord injury lawsuit. A report in Journal of Neurosurgery determined that surgical malpractice accounted for 43% of SCI suits.
Another type of spinal cord injury malpractice is due to the healthcare provider’s failure to diagnose a SCI despite apparent symptoms or relevant test results. A delayed diagnosis or a failure to order appropriate tests and imaging can lead to a spinal cord injury claim, or a spinal injury claim, if it prevents timely treatment and therefore leads to exacerbation of the injury or transforms what could have been reparable damage into permanent impairment. Diagnostic errors are estimated to account for 18% of SCI malpractice cases.
This sort of spinal cord injury malpractice most commonly occurs during emergency treatment, such as when an accident victim is not properly immobilized before being transferred to an ambulance. In addition to making an existing SCI worse, improper handling can cause secondary injuries such as shearing or pressure sores.
Spinal cord injury surgery can be considerably more complex and take longer than other types of procedures, increasing the risk of anesthesia errors such as administering too little or too much medication, failing to monitor vital signs, and delayed or unsuccessful intubation.
This type of mishap can be considered a subset of anesthesia errors. In a worst-case scenario, incorrect placement of the needle during administration of an epidural can produce spinal cord infarction or other nerve damage, resulting in permanent paralysis, lack of sensation, or long-term pain. Spinal injection errors can also cause hematomas, hemorrhages, and abscesses. Most of these types of complications are natural risks of the procedure but failure to timely diagnose and treat a spinal cord compression injury when it does occur can make all the difference between a successful defense and a settlement.
Just as mothers giving birth can suffer SCIs due to epidural placement errors, babies sometimes receive SCIs during delivery. The use of forceps, vacuum extractors, or excessive force during a difficult delivery can lead to paralysis and other disabilities that might require long-term spinal cord injury rehab and lead to a birth injury lawsuit. Failing to perform a C-section during such a delivery can also contribute to a spinal cord injury claim.
SCIs can result from or be compounded by medical negligence after surgery. Perhaps staff shortages mean a patient isn’t repositioned as frequently as necessary, leading to skin ulcers that become infected, or due to a lack of effective communication, doctors don’t receive nurses’ notes regarding worsening symptoms, resulting in failure to diagnose autonomic dysreflexia.
Procedures meant to alleviate pain and improve mobility sometimes have the opposite effect. These include decompression surgeries such as diskectomies and laminectomies, intended to eliminate pressure on the spinal cord by removing damaged discs or part of the lamina. Spinal fusion, another type of surgery, uses hardware or bone grafts to join vertebrae together to stabilize the spine or stop pain resulting from slipped vertebrae colliding with those above or below it. Complications from surgery to remove spinal tumors or infections might also incur spinal cord injury malpractice suits.
A spinal cord injury can occur even if the original injury being treated doesn’t directly affect the spine. Improper handling of someone suffering a pelvis injury can cause a bone fragment to damage the spinal cord, for instance, just as manipulating peripheral joints might lead to an SCI in someone with an underlying condition such as severe osteoporosis.
Dismissing an ER patient’s complaints of back or neck symptoms without ordering diagnostic imaging, discharging a patient prematurely, and failing to get informed consent are types of emergency room errors that can result in a spinal cord injury lawsuit.
Because epidurals are placed near the spinal cord, they’re the pain management injections most commonly associated with SCIs. However, other injections can also damage the spinal cord. For example, injecting particulate steroids such as Kenalog near the spine can block certain blood vessels, resulting in infarction or paralysis.
Failing to assess a patient via imaging to identify any potential anatomical issues prior to an injection or not using fluoroscopy while injecting might also result in long-term injuries that can result in liability.
We wrote a blog concerning smart goals for pain management, read it today!
Both incomplete and complete SCIs are seen in malpractice cases, and an incomplete spinal cord injury can have as much of an impact on a patient as a complete injury. That’s because the number of limbs affected and the severity of the SCI also determine how catastrophic the impact.
Paraplegia affects the lower portion of the body including the legs and pelvic organs, while quadriplegia or tetraplegia affects all four limbs plus the torso and its organs. Loss of bowel or bladder control and changes in sexual function are also common consequences of spinal cord injuries, regardless of the level or completeness of the injury. Hemiplegia, in which the limbs on one side of the body are affected, sometimes occurs as well. In some instances, incomplete tetraplegia might affect an individual’s livelihood and quality of life more than complete paraplegia.
Wrong-site surgery, improper placement of screws or rods during surgery, and missed diagnosis of a herniated disc are among the types of spinal cord injury malpractice that have resulted in a nerve root injury. Also known as radiculopathy, this type of injury occurs when a nerve attached to the spinal cord is compressed or otherwise damaged, generating localized pain.
Cauda equina syndrome or injury, a severe type of nerve root injury, involves damage to the group of nerves at the base of the spinal cord. If the compression of those nerves is not relieved on an urgent/emergent basis, the resulting leg pain and weakness, numbness of the groin and buttocks, and incontinence can be permanent and would be considered secondary injuries due to delayed treatment.
Secondary injuries can result from other traumatic and non-traumatic SCIs as well. These include persistent headaches due to failure to detect a dural tear either during surgery or afterwards, pressure ulcers resulting from a patient not being turned in a timely manner, and recurring urinary tract infections.
Living with a spinal cord injury can in and of itself lead to secondary cognitive and psychological damage. Some pain medications impair memory and attention span; a decline in quality of life can result in depression. Research suggests that sleep apnea, autonomic dysfunction, and other complications result in a 13 times higher risk of cognitive impairment among those living with a SCI than in those who aren’t.
As with any other claim for medical malpractice, in a spinal cord injury claim, the plaintiff must prove the following: four key elements.
Defendants can mitigate their liability risks by hiring an expert medical witness to clarify the details of the injury and the treatment, prove that the medical practitioners followed proper practices, and even highlight flaws in the plaintiff’s case.
Not every injury is the result of medical negligence, in fact medical negligence is typically not the cause of an injury.If an expert witness can explain how an injury is not the result of medical negligence, this can sometimes prevent claims from going to court as well as potentially reduce the amount paid in spinal cord injury settlements.
Spinal cord injury malpractice claims are costly because living with a SCI is costly. In the first year post-injury alone, a patient can expect to spend up to $1.4 million, depending on the severity of the SCI and the patient’s age. Depending on the degree of spinal cord injury recovery, lifetime costs can exceed $3 million.
That sum does not include the patient’s temporary or permanent loss of wages, and only 35% of patients with a traumatic SCI return to work. Nor does the sum include the lost wages of family or household members who become part- or full-time caretakers.
Even when patients show signs of recovery from a spinal cord injury, they continue to rack up expenses, as physical therapy for spinal cord injury can be lifelong and may not be covered by insurance. What’s more, wheelchairs and other assistive equipment typically need repairs or replacement over time, and these often are not covered by insurance either.
The financial burdens, loss of independence, chronic pain, physical limitations, and loss of consortium caused by many spinal cord injuries can take a significant toll on quality of life. One study found that on a 100-point scale, patients with SCIs scored 10–70 points lower than the general population; another revealed that 18%–37% of those with traumatic SCIs showed signs of major depressive disorder.
The potentially catastrophic effects of SCIs might leave medical professionals susceptible to nuclear verdicts. In 2025, a jury awarded $60 million to an electrical mechanic who was left a paraplegic following what was supposed to be a routine lumbar epidural steroid injection for back discomfort.
Later that same year, a married couple were awarded $27 million after a jury found that medical staff failures led to delays in the diagnosis and treatment of a post-surgery hematoma, resulting in the husband experiencing partial paralysis, leg spasms, and nerve pain and the wife suffering a loss of consortium.
Although out-of-court medical malpractice settlements are typically lower than court rulings, they can nonetheless be sizable. A report in Journal of Neurosurgery found that the mean settlement was $1,930,278–$2,113,593.
The complexity of malpractice litigation in general, and of SCIs in particular, presents challenges to both defendants and plaintiffs.
To prove factual causation, also known as cause in fact, plaintiffs frequently apply the “but for” test; this attempts to show that the patient would have had a better outcome but for the defendant’s negligence or error. Plaintiffs might also try to prove proximate cause, or that the injury was a probable result of the defendant’s breach of duty. Conversely, defendants try to prove that the spinal cord injury resulted not from medical treatment or lack thereof but from the patient’s existing disease or an unavoidable risk.
Just about every treatment carries known risks; those of spinal surgery include blood clots, bleeding, nerve damage, dural tears, infections and even death. Defendants will often point out the risks of the procedure and the patient’s informed consent following disclosure of those risks as a defense, but that will not override negligence or failure to adhere to an accepted standard of care.
Both sides wield medical records, along with scientific studies, timelines, and expert testimony, to prove their case and disprove that of the opposition. Inaccurate, incomplete, or generic documents are a factor in 10%–20% of malpractice cases, which underscores the importance of charting with a jury in mind.
Particularly in auto accidents and other types of trauma, a spinal cord injury might not immediately be symptomatic. However, failure to conduct routine imaging or to recognize symptoms hours after the incident can cause the SCI to progress to the point of irreparable damage.
This is an example of delayed symptom onset malpractice; others include misinterpreting or dismissing symptoms that arise days, weeks, or even months afterward. Key in these cases is trying to determine to what extent the injury is the result of the original trauma and what, if any, is the result of any delayed treatment.
Plaintiffs will typically present both economic as well as noneconomic damages. Medical and rehab costs, home care, assistive equipment, and loss of wages and other forms of economic damages are often easier to calculate than noneconomic damages such as pain, emotional distress, and diminished quality of life.
The medical malpractice statute of limitations varies from state to state, but the definition is consistent: the maximum period of time following an alleged incident, injury, or negligence that a patient has to initiate legal proceedings. In New York State, for instance, patients generally have 30 months from the date of the incident or the end of continuous treatment to file a malpractice claim.
Knowing the applicable statute of limitations helps ensure that medical professionals maintain documentation for the appropriate period of time. However, in most jurisdictions a number of factors can alter the time period.
For instance, the discovery rule typically allows the statute of limitations to begin from the day the patient discovered the injury, or from the day from which, with the exercise of reasonable diligence, they should have discovered the injury. For example, if surgery occurred in July but the patient wasn’t aware that they’d suffered a secondary spinal cord injury potentially caused by negligence until October, the statute of limitations may begin to run in October rather than July.
A few states also have a corresponding statute of repose that establishes an absolute deadline for initiating a suit regardless of the date of discovery.. Other exceptions apply when the patient is a minor, in the case of fraud, or regarding instances such as a foreign body being left in the patient.
It’s also important to understand the difference between a medical malpractice suit and a wrongful death lawsuit. Like malpractice, wrongful death requires proving a breach of duty on the part of the medical professionals. In wrongful death litigation, however, it’s the surviving family members or the deceased’s estate that files suit, and the damages are for funeral expenses, lost income, and grief.
No, not all spinal cord injuries qualify as malpractice. An injury is considered to be caused or partially caused by medical malpractice only if a breach of duty on the part of the healthcare provider caused or exacerbated the injury.
A spinal cord injury affects the brain by injuring or severing the nerves between the brain and other parts of the body, which can lead to gliosis and/or chronic neuroinflammation in the brain itself. This in turn can result in cognitive decline including memory loss and language difficulties, depression, anxiety, and phantom pain.
A known surgical risk can still be considered malpractice if the ensuing injury resulted from a preventable error, negligence, or another breach of duty on the part of the healthcare practitioner. Failure to adequately inform the patient of the possibility of the risk and receive the patient’s informed consent can also be malpractice.
Yes, a healthcare provider can be held liable for malpractice if a spinal cord injury or its symptoms that appear after medical treatment are due to a breach of duty. For instance, a sudden headache and sweating several months after an injury are common symptoms of autonomic dysreflexia; a practitioner who dismisses the symptoms, only for the patient to suffer a stroke, could be subject to malpractice claims.
SCIs are among the most catastrophic, and costly, injuries a physician can face in a malpractice claim. The median spinal cord injury settlement exceeds $1.6 million, roughly four times the average malpractice payout, and nuclear verdicts in the tens of millions are not unheard of. Surgical errors, missed diagnoses, and post-procedure negligence all carry significant exposure, and the complexity of SCI litigation means claims are rarely simple or quick to resolve.
Strict adherence to accepted standards of care reduces risk, but can’t eliminate it entirely. Documentation gaps, delayed symptom onset, and the inherent risks of spinal procedures mean that even careful physicians can find themselves named in a lawsuit.
That's exactly why the right malpractice coverage matters. Indigo's AI-powered platform is built specifically for physicians, delivering fast, accurate quotes tailored to your specialty and practice profile, so you're not left guessing whether your coverage is adequate when the stakes are as high as you know they are.
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