In this blog, I’ll be addressing personal injury cases, specifically motor vehicle accidents, one of the seven types of cases Barber Medical Legal Nurse Consulting, LLC can review. In the event of a personal injury case involving a motor vehicle accident (MVA), the plaintiff has a history of ankylosing spondylitis (AS). The plaintiff has a 5-year history of low back and bilateral hip pain.  Status post MVA, the plaintiff reports worsening mid to low back and left hip pain with a new onset of left leg pain radiating down the full length of extremity associated with numbness and tingling making it difficult to stand or walk for long periods of time.

 Is this a non-meritorious case secondary to a pre-existing medical condition?  Or, is this a meritorious case secondary to exacerbation of a pre-existing medical condition as a result of the MVA?

Per Patient Safety in Surgery, cited in Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis, (AS) is:

  • A chronic system wide inflammatory rheumatic disorder primarily affecting the axial skeleton (sacroiliac joints and spine)
  • Characterized by remissions (reduction in severity of disease symptoms), and exacerbation (acute increase in severity of disease symptoms).  Exacerbation’s can be triggered by traumatic incidences, such as an MVA.  Exacerbation’s should be distinguished from traumatic lesions which have been reported to occur in rigid AS spines (which usually resolve within two weeks.) 

>The defense is likely to argue that the damages were unavoidable and were due to a pre-existing condition of AS.

The below links are useful resources specific to AS with a great case study in the first link provided:

Handle with care: the dangers of cervical spine fracture in patients with ankylosing spondylitis. (Cases in Point).   

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis.

P.S. Comment and share what your thoughts are about the merits of the case based on the limited information provided

P.P.S. Comment and share if you have experience with a personal injury case involving a plaintiff with a history of AS. How did this medical history impact the outcome of the case?