A patient with IV drug use history presents with back pain and fever. The treating physician diagnoses musculoskeletal pain without pursuing emergent spinal imaging. The epidural abscess compresses the spinal cord, and by the time surgical decompression is attempted, the patient has developed irreversible paralysis. Covers premature closure and attribution bias, the 56% diagnostic error rate for spinal epidural abscess, and multiple high-value verdicts ($5.6M–$18M).

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