Medicolegal aspects of epidural steroid injections

Objectives

The clinical use of epidural steroid injection and related legal claims have increased over time. Practitioners in the field of Pain Medicine must be aware of their ethical and legal responsibilities to their patients. Physicians must also be cognizant of how their own behavior may be a liability.

Methods

We performed a literature search using the PubMed and American Society of Anesthesiologists database for articles and guidelines related to epidural steroid injections and/or chronic pain. Further information was obtained via the LexisNexis database, including legal cases in which complications resulting from an epidural steroid injection had formed the basis of a medical malpractice action. The legal duties of physicians, as set forth in United States law, were also reviewed.

Conclusions

Legal claims are filed against people who do everything correctly and those who do not—their outcome does not necessarily reflect justice. The practice of medicine is an art, which combines knowledge, technical skill, and interpersonal relations. Physicians must take a leading role not only in the medical care of their patients, but as educators in the legal arena. Where physicians fail to do so, others who lack medical training and an appreciation of the subtleties of the art will, of necessity, dictate the standards of medical care.

Keywords: Breach of duty, Causation, Chronic pain, Complication, Damages, Duty