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The sting of injection: Steroid shots lead to more malpractice suits

Have you ever gotten a steroid shot to treat serious muscle pain? If you suffered negative side effects, you're not alone. An increase in steroid injections used to treat pain has resulted in a surge of severe complications, including paralysis and even death. These complications have led to medical malpractice lawsuits, as well as a review by the U.S. Food and Drug Administration into the safety of the injections.

About 8.9 million Americans received steroid injections last year. The treatment takes only minutes and reimburses doctors handsomely through Medicare and private insurance. It's become the most popular way for U.S. physicians to treat neck and back pain, according to research studies. Americans spent $23 billion on epidurals this year, a 231 percent increase in the past decade.

But for all their popularity, the shots are not without risk. The FDA is focusing its review on injections with the transforaminal approach, which brings a needle within millimeters of critical arteries feeding the spinal cord. Many doctors prefer this method because it delivers the solution closer to the nerves that cause pain. About half of all shots administered last year were done this way. Another danger is the use of particulate steroids, which are slow to dissolve and could create a blockage that triggers a stroke if accidentally shot into an artery.

Complicating matters is the absence of a comprehensive system to track complications from steroids or any other drugs. Although drugmakers are required to report any harmful results they hear of to the FDA, health care professionals are not. This is probably why until recently, steroid injections weren't thought to be harmful beyond the occasional headache. That is, until malpractice suits began surfacing with cases involving paralysis and death of patients who'd received the shots. Earlier this year, 31 malpractice claims identified people who suffered spinal cord injuries and eight people who had a stroke after receiving the shots in the neck.

In addition to the drug itself and the location of the injection, the doctor giving the shot can add risk to the procedure. Doctors who give epidurals in hospitals are usually reviewed by a credentialing committee and assigned a monitor. But in other settings, doctors may not require any special training. Medicare patients receive transforaminal epidurals in a doctor's office more than anywhere else, according to an audit by the U.S. Department of Health and Human Services.

If you've suffered serious complications from a steroid injection, you may want to consult an attorney experienced in medical malpractice lawsuits. Consider it another form of pain management.

Source: Businessweek, "Epidurals Linked to Paralysis Seen With $300 Billion Pain Market," David Armstrong, Jan. 4, 2011

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