After MRI, Local Hospital Transfers Patient to University Hospital... Supreme Court Rules "Substandard Care Must Be Examined"

Paralysis of Lower Limbs After Transfer from Clinic-Level Hospital... 1st and 2nd Trials "Not Resident's Fault"
Supreme Court "Checked MRI Independently Without Radiology Department's Interpretation"

If a patient who visited due to back pain underwent MRI examination and was then sent back to a clinic-level medical institution, resulting in paralysis of the lower limbs, the Supreme Court has ruled that the ‘negligent treatment’ of the university hospital that initially treated the patient must be examined.

The Supreme Court's First Division (Presiding Justice No Tae-ak) overturned the lower court ruling that dismissed the damages claim filed by Mr. A and his family against B University Hospital and remanded the case to the Daejeon High Court on the 30th.

In October 2014, Mr. A visited the emergency room of B Hospital with symptoms including back pain. Although the resident doctor performed lumbar MRI and confirmed an epidural hematoma, he diagnosed only spinal stenosis and herniated disc and transferred Mr. A to a clinic-level medical institution.

Subsequently, Mr. A experienced paralysis symptoms in his legs and severe pain, was readmitted to B Hospital, and underwent emergency surgery but was diagnosed with permanent paralysis of the lower limbs. In March 2018, Mr. A and his family filed a lawsuit against the hospital, claiming that the resident’s negligence caused the permanent disability.

The first and second trials ruled that the resident was not at fault. They reasoned that transferring the patient instead of performing surgery was within the reasonable scope of medical treatment choices. The courts stated, "It cannot be concluded that Mr. A’s failure to receive prompt surgery was due to the resident’s failure to inform about bleeding symptoms at the time of transfer, and since only mild neurological symptoms were present at that time, there was no obligation to explain or perform surgery or other medical procedures."

However, the Supreme Court judged that the lower courts erred by not considering various circumstances, such as the possibility that the resident failed to diagnose the epidural hematoma by reviewing the MRI independently without a radiologist’s interpretation. Essentially, the Supreme Court indicated that the issue of negligence should be re-examined.

The court stated, "It should be examined whether the resident was in a position to easily diagnose the epidural hematoma from the lumbar MRI, whether conservative treatment at that time was appropriate if the diagnosis was missed, whether sufficient information or explanation about the epidural hematoma was provided to Mr. A and his guardian at the time of transfer, and if these measures were not properly taken, whether they influenced Mr. A’s paralysis of the lower limbs. The court should verify the breach of duty of care and the hospital’s liability for damages."

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