Portland Jury Awards $10M in Case Highlighting Imaging Delays in Spinal Emergency

A Portland jury has awarded $10 million to John Douglas Cox, a 62-year-old diesel mechanic, in a case underscoring the critical role of timely and appropriate imaging in diagnosing spinal emergencies.

The jury allocated 80% of the fault to Kaiser, which was not a defendant at trial, and 20% to the treating physicians.

The case centers on a December 2021 emergency department visit in which Cox presented with sepsis and rapidly progressing paralysis beginning at the T7 level. He was later diagnosed with a spinal epidural abscess, a condition requiring urgent imaging and surgical decompression to prevent permanent neurological injury.

Although an emergency physician recognized acute neurological decline and ordered imaging, testimony revealed significant delays tied to uncertainty over whether Cox’s implanted spinal cord stimulator was MRI-compatible. According to plaintiff attorney Jane Paulson, staff waited for authorization from an out-of-town physician rather than escalating the issue or contacting a device representative to confirm compatibility.

Cox remained in the emergency department for nearly 17 hours as his paralysis progressed. When imaging was eventually performed, it focused on the wrong region of the spine and failed to identify the abscess.

He was subsequently transferred to Kaiser, where additional imaging confirmed a spinal epidural abscess compressing the spinal cord. Surgery was performed more than 27 hours after his initial arrival.

Medical experts testified that rapid access to appropriate imaging—particularly MRI—and timely surgical intervention are essential to prevent irreversible spinal cord injury in such cases.

“This verdict reflects the jury’s recognition that when a patient arrives in the emergency department with rapidly progressing paralysis, every hour matters,” said Paulson. “This case was about accountability and patient safety.”

She added, “Our client did everything he could to get help — he even emailed his own doctor from the emergency room saying he was ‘going paralyzed’ and was terrified he might never walk again.”

Defense attorneys argued earlier intervention would not have changed the outcome, but the jury disagreed.

Cox, who worked nearly three decades as a diesel mechanic, now lives with permanent neurological impairment and limited mobility.

The case is John Douglas Cox vs Kaiser, et al., Multnomah County Case No. 23CV40984.