Litigation Involving Delay of Spinal Care During the COVID-19 Pandemic: A Review of Reported Legal Cases in the United States

Abstract

Background

During the coronavirus disease 2019 (COVID-19) pandemic, access to medical care was delayed worldwide. In multiple instances, the pandemic has led to delay in care, suboptimal 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 the legal database 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 spinal pathology, delay length and reason, legal cause of action, state/region of occurrence, and case outcome.

Results

Thirty-two cases met the criteria for full review. The average reported delay in litigated cases 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 disease with pain as the predominant symptom (96.88%), followed by neurological 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 provides granular detail about the characteristics of litigation related to delay of spinal care secondary to the COVID-19 pandemic in the United States. Most plaintiffs were inmates who had difficulty obtaining a specialist appointment, imaging, or treatment. In many cases the reason for litigation were unattended requests for simple and low-cost interventions.