Litigation Involving Delay of Spinal Care During the COVID-19 Pandemic: A Review of Reported Legal Cases in the U.S.

Abstract

Background: During the COVID-19 pandemic, access to medical care was delayed around the world. This has led to poor patient outcomes and litigation. This study was designed to assess the incidence and characteristics of litigation in the United States related to delays in spine care secondary to the COVID-19 pandemic.

Methods: A retrospective review of LexisNexis following PRISMA guidelines was conducted. LexisNexis was queried for cases, verdicts, and settlements involving a delay of spinal care during the COVID-19 pandemic. Collected data included plaintiffs' demographics and spine pathology, delay length and reason, legal cause of action, state/region, and case outcome.

Results: Thirty-two cases met criteria for full review. The average reported delay was 5.64 ± 3.83 months, with 25% having not received the necessary spinal care at the time the claim was filed, most of which were in 2022. Most cases involved lumbosacral pathology with pain as the predominant symptom (96.88%), followed by neurologic deficits (25%). Most cases (62.50%) involved inmates and were based on a claim of cruel and unusual punishment in violation of the 8th Amendment of the U.S. Constitution.

Conclusions: This study provided granular detail about the characteristics of litigation related to delay of spinal care due to the COVID-19 pandemic in the U.S. Most plaintiffs were inmates who had difficulty obtaining a specialist, imaging, or treatment. A substantial proportion of the remaining cases were associated with unattended requests for simple and low-cost interventions.