What happens when a doctor orders an MRI or CT scan and cancels it before it’s done?
This is the exact question I investigated on behalf of a client who had a back surgery (lumbar laminectomy) at a Houston-area hospital.
Within a day or two after his surgery, the nursing staff noted in the medical record that he had lower-extremity weakness, urinary retention (he wasn’t able to urinate), numbness below the waist, and a bad headache. A nurse used a straight catheter to drain his bladder but didn’t notify the surgeon.
About seven hours later, his bladder was full again. A nurse finally picked up the phone, called the surgeon, and told him about some of the problems, focusing on the urinary retention.
The surgeon ordered a Foley catheter and an MRI scan. The surgeon’s MRI order listed the clinical indication (or reason for the scan) of urinary retention.
Fast forward seven and a half hours. The urinary retention persisted. So did the headache, numbness, and abnormal lower extremity reflexes. But the MRI hadn’t been done. The surgeon finally showed up to see this patient and did an exam. He noted in the medical record that the patient had urinary retention but canceled the MRI scan.
At his deposition, I asked the surgeon why he ordered the MRI in the first place. He had a bit of an uncertain look on his face and testified that he ordered the MRI because the nurse had called him to report a change in the patient’s status, he didn’t have all the information, and he needed to see what was going on.
There are a lot of strange things about this sequence of events.
• Why did the nurses wait seven hours before telling the surgeon about the patient’s deterioration?
• What was the surgeon thinking when he ordered the MRI because of urinary retention?
• Why didn’t the hospital perform the MRI scan in seven and a half hours?
• Why did the surgeon wait over seven hours before seeing the patient?
• Why did the surgeon cancel the MRI when he still didn’t have answers for what was causing the patient’s urinary retention?
• Was there a cover-up because the hospital, nurses, and surgeons were so sluggish?
Unfortunately, this cluster of medical errors left my client with permanent numbness from the waist down and with loss of bowel, bladder, and sexual function. Our surgical medical expert testified that this could have been avoided if the MRI had been done, which would’ve led to a return to surgery to remove a dangerous hematoma (accumulation of blood) that was compressing the patient’s spinal cord and nerve roots.
What you should know
From my experience as a Houston, Texas medical malpractice lawyer, I know that a physician doesn’t order an MRI or CT scan unless there’s a good reason. As a patient, here are some things that I recommend you do to keep yourself safe, particularly if you’re in a hospital:
When a doctor orders an MRI, CT, or other type of diagnostic radiology study, ask for the reason she’s ordering the scan.
Ask whether the scan is going to be done routine or stat (as soon as possible), and when she expects the scan will be performed.
If you aren’t taken to the radiology room for the scan within the expected time period, speak up and ask the nurse about the delay.
If you learn that the scan is canceled, ask for an explanation why.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also, in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.