It may have come on suddenly. A sharp, severe pain in your back or neck, often out of nowhere.
The pain may have shot into your arms or legs. And then, over minutes or hours, something frightening happened. Your legs grew weak. You felt numbness creeping in. Maybe you could not move them at all. Maybe you lost control of your bladder or bowels. It felt like something was pressing on your spine, and it was getting worse fast.
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Article written by Brendan Lupetin, Esq. Brendan is a managing partner in the law firm of Lupetin & Unatin, a medical malpractice law firm located in Pittsburgh and serving Western Pennsylvania.
Our practice is limited to high-value catastrophic cases because that is where we can do the most for our clients and for patient safety.
Maybe there was a reason it happened. You were on a blood thinner. You had a recent spinal injection, an epidural, or a spinal tap. You had recent back surgery. Or it came with no clear cause at all. You went to the ER. You described the sudden pain and the weakness. And maybe they treated it like ordinary back pain, or a pinched nerve, or even a stroke. Maybe they did a CT that looked normal and stopped there. The whole time, blood was pooling around your spinal cord, squeezing it.
By the time someone ordered the right scan and called a surgeon, the window may have closed. A spinal hematoma can cause permanent paralysis if the blood is not drained fast. Maybe you survived but cannot walk, or lost control of your body. Maybe you are reading this because someone you love did not survive. And you cannot stop asking: why didn’t they catch this in time?
That question matters. A spinal hematoma is a true surgical emergency, and the window to prevent permanent paralysis is short. When it is missed or treated too slowly, the harm is often catastrophic and often preventable. This article explains the warning signs that a spinal hematoma was missed. It explains the serious harm a delay can cause. And it explains what you can do next. If any of this sounds like your story, Lupetin & Unatin is here to help.
What a Spinal Hematoma Is, in Plain Terms
A spinal hematoma is a pocket of blood that collects in the spaces around the spinal cord, usually the epidural or subdural space. As it grows, it presses on the spinal cord and the nerves, cutting off their blood supply and crushing them.
As the Cleveland Clinic explains, an epidural hematoma can cause brain or spinal cord damage shown by weakness, numbness, and paralysis, and in severe cases coma or death. A spinal hematoma is diagnosed with an MRI or CT of the spine. The treatment is usually urgent surgery to drain the blood and relieve the pressure, along with reversing any blood thinners.
The key word is time. The deficits can progress over minutes to hours. The sooner the blood is drained, the better the chance of recovery. Once the spinal cord has been compressed and starved for too long, the damage can be permanent. That is why a fast diagnosis and fast surgery matter so much.
Why a Spinal Hematoma Gets Missed
A spinal hematoma is rare, and it can look like other things. The first symptom is often severe back or neck pain, which is extremely common and usually harmless. When weakness follows, it can be mistaken for a stroke, a pinched nerve, or a disc problem. So the real cause can be chased in the wrong direction while the clock runs.
But doctors are trained to suspect it, especially in high-risk patients. As the Merck Manual explains, doctors should suspect a spinal hematoma in a patient with local or radicular back pain and tenderness, or with sudden, unexplained leg weakness, especially when there is a possible cause like trauma or a bleeding tendency, and the diagnosis is made by MRI. When those clues are present and no urgent scan is ordered, an abscess of blood can crush the cord while a treatable emergency goes unrecognized.
Here are the common reasons a spinal hematoma gets missed:
- Sudden severe back or neck pain was treated as a routine strain.
- Weakness was blamed on a stroke or a pinched nerve, with no spine imaging.
- The patient was on a blood thinner and that risk was not considered.
- A recent spinal procedure or injection was not connected to the symptoms.
- Only a CT was done and read as normal, with no MRI to follow.
- No surgeon was called once the warning signs appeared.
Risk Factors Doctors Are Supposed to Consider
Some people are at much higher risk of a spinal hematoma. These risk factors matter twice. They make the condition more likely. And they are supposed to raise a careful doctor’s suspicion when a patient has sudden back pain and weakness.
Common risk factors include:
- Blood-thinning medications. Anticoagulants like warfarin, heparin, and the newer blood thinners are a major risk factor. A patient on these with sudden back pain and weakness should raise immediate concern.
- Recent spinal procedures. Epidural injections, spinal anesthesia, and spinal taps can cause bleeding around the cord.
- Recent spine surgery. Bleeding can collect after an operation on the spine.
- Bleeding disorders. Conditions that keep the blood from clotting normally raise the risk.
- A blow to the back can cause bleeding around the spinal cord.
- Vascular malformations and high blood pressure. Abnormal blood vessels or very high blood pressure can lead to a spontaneous bleed.
Here is why this matters for your case. A patient on blood thinners, or who recently had a spinal injection or surgery, who comes in with sudden back pain and weakness, is not a routine backache. A careful doctor should think about a spinal hematoma and order an urgent MRI. When those clues are in the chart and the doctor still treats it as something minor, that can be a failure to meet the standard of care.
Signs Your Spinal Hematoma Was Missed
Below are the red flags. If you recognize several of these, it may be worth a closer look at the care that was given.
- You Had Sudden, Severe Back or Neck Pain With Weakness. The classic pattern is sudden, severe back or neck pain followed by weakness or numbness that gets worse. If you had this pattern and it was treated as a simple strain, that is a major red flag.
- Your Blood Thinner Was Not Considered. Being on a blood thinner is one of the biggest risk factors for a spinal hematoma. If you were on one, had these symptoms, and no one connected the dots, the diagnosis may have been missed.
- A Recent Spinal Procedure Was Not Connected to Your Symptoms. If you recently had an epidural, a spinal tap, spinal anesthesia, or back surgery, and then developed severe back pain and weakness, that history is a major clue. If no one connected it to a possible bleed, that is a red flag.
- Your Weakness Was Blamed on Something Else. Spinal hematoma can be mistaken for a stroke or a pinched nerve. If your weakness was treated as one of those without imaging your spine, a treatable emergency may have been missed.
- No Urgent MRI Was Ordered. An MRI is the test that finds a spinal hematoma. A plain CT can miss it. When the signs and risk factors point to a hematoma, an urgent MRI should be ordered. If only a CT was done, or imaging was delayed, that gap could be a failure to meet the standard of care.
- Surgery Was Delayed After the Diagnosis. Once the hematoma is found, surgery to drain it should happen fast, and blood thinners should be reversed. If the diagnosis was made but the surgery was delayed, that delay can be the difference between recovery and permanent paralysis.
- You Suffered Lasting Harm. Sometimes the clearest sign that something went wrong is the outcome itself. People treated quickly often recover. When treatment comes too late, the damage can be permanent. The next section covers the serious harm a delay can cause.
The Serious Harm a Spinal Hematoma Delay Can Cause
When the blood is not drained in time, it crushes the spinal cord. The longer the delay, the more harm it does. Here are the serious injuries and outcomes a missed or delayed diagnosis can cause.
Permanent paralysis. This is the most feared outcome. When the spinal cord is compressed for too long, paralysis of the legs, or of all four limbs, can be permanent.
Loss of bladder and bowel control. Pressure on the nerves can cause lasting loss of control over the bladder and bowels.
Loss of sensation. Numbness and loss of feeling below the level of the hematoma can be permanent.
Inability to walk. Even short of full paralysis, the nerve damage can leave a person unable to walk without help, or at all.
Chronic, severe nerve pain. Many survivors live with constant burning or shooting pain that is hard to treat.
Sexual dysfunction. The nerves that control sexual function can be permanently damaged.
Lasting disability and lifelong care. Many survivors need wheelchairs, catheters, and ongoing care, and cannot return to the life they had before.
Death. In severe cases, the hematoma or its complications can be fatal. If you lost a loved one this way, your family may have a wrongful death claim.
Emotional trauma. Losing the use of your body, or losing a loved one, leaves deep wounds. Many people and families struggle with depression, anxiety, and grief for years.
Many of these outcomes share one thing in common. They often trace back to time that was lost. Time that doctors had to act, and did not use.
When a Missed Diagnosis Becomes Malpractice
Not every bad outcome is malpractice. Doctors do not have to be perfect, and a spinal hematoma is rare and can be hard to diagnose. But doctors do have to meet a basic standard. That standard is the level of care a careful doctor would have given in the same situation.
To have a malpractice case, a few things usually need to be true. First, there was a doctor-patient relationship. Second, the care fell below the accepted standard. Third, that failure caused real harm. Fourth, the harm led to losses, such as medical bills, lost income, the loss of a loved one, or pain and suffering.
Spinal hematoma cases often turn on a few key questions. Did the patient have sudden back pain and weakness? Were the risk factors, like blood thinners or a recent procedure, considered? Was an urgent MRI ordered? Was surgery done in time? When the signs were there and no one acted, that delay can be the heart of a strong case. A delayed diagnosis of a bleed compressing the spinal cord is among the root causes of malpractice leading to brain and spinal cord injuries. Proving it takes work, records, and the right medical experts. That is where Lupetin & Unatin comes in.
What You Should Do Now
If you think your spinal hematoma, or that of a loved one, was missed, take these steps.
Get the medical records, including all imaging. You have a right to them. The timeline, the medication list, and the scans are often the heart of the case.
Write down what you remember. Note when the pain started, when the weakness began, and how fast it progressed. Note any blood thinners you were taking and any recent spinal procedures. Note what tests were done and how long everything took. Memory fades, so do this soon.
Do not wait too long to ask questions. Every state has a deadline for filing a malpractice claim. In Pennsylvania, that deadline is usually two years. There are some exceptions, but the clock can run out fast. Acting early protects your rights.
Talk to a lawyer who knows these cases. Spinal hematoma claims are complex. They need medical experts and a deep understanding of emergency, neurological, and surgical care. A general lawyer may not be the right fit. A firm focused on medical malpractice will know what to look for.
How Lupetin & Unatin Can Help
We are Lupetin & Unatin. We are a Pittsburgh medical malpractice firm. We focus on serious injury and death from medical errors. Cases involving missed and delayed diagnosis, including bleeds that compress the spinal cord, are at the heart of our work. We know how these errors happen. We know how hospitals defend them. And we know how to hold them accountable.
We have handled catastrophic delayed-diagnosis cases involving permanent paralysis and spinal cord injury. We understand how a treatable emergency can become a lifelong disability when the warning signs are missed and the clock runs out. We know the medicine, and we know how to prove what a careful doctor should have done.
We take a small number of cases so we can give each one real attention. We work on contingency. That means you pay nothing up front. You pay nothing unless we win. There is no risk in finding out if you have a case.
You deserve answers. You deserve to know if this suffering or loss could have been prevented. A short conversation can tell you a lot.
Frequently Asked Questions
You may not know for sure on your own. That is normal. The answer is usually in the medical records. We look at what symptoms you reported, what risk factors you had, whether the doctors considered a bleed, whether an MRI was ordered, and how long everything took. This condition is rare, but the law asks what a careful doctor would have done with the same information, especially in a high-risk patient. A careful review tells us whether the care fell below the standard. That review costs you nothing.
In most cases, the deadline in Pennsylvania is two years. For a wrongful death claim, that period generally runs from the date of death. Some exceptions can change the deadline. These rules are tricky. The safest move is to call us soon so we can protect your rights before time runs out.
Nothing up front. We work on contingency. That means we only get paid if we win money for you. There is no fee to talk with us and no fee to review your case. If we take your case and do not win, you owe us no attorney fee. This lets you seek justice without financial risk.
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Reach Out Today
A spinal hematoma can take away the use of your body in a matter of hours. A missed diagnosis can change everything. If a hospital or doctor failed you or someone you love, you have the right to seek justice. If any part of this article sounds like your story, please contact Lupetin & Unatin. Tell us what happened. We will listen. We will review the records. We will tell you honestly whether we think there is a case. Let us help you find out what really happened.