A jury in Wyoming recently ruled in favor of Louis Prager, a 51-year-old field worker, awarding him and his wife a record-breaking $9 million in damages after an ED physician at a regional hospital did not order neck X-rays or CT scans after an accident.

The plaintiff’s truck slid off an icy road, rolled over several times and landed upside down, after which emergency medical service workers freed him, immobilized him using a backboard and then put him in a neck brace to prevent further damage.

Prager arrived at Campbell County Memorial Hospital in Gillette, WY, wearing the neck brace and was seen by ED physician Brian Cullison. Cullison ordered X-rays and CT scans of Prager’s head, thoracic spine and facial bones, but not his neck, despite the patient’s complaints of neck pain. Cullison released Prager without a cervical collar and had not performed a physical exam.

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After four days with extreme pain in the left shoulder and neck, and weakness in the arm, Prager returned to the hospital. Further testing revealed a broken neck, which required emergency neck-fusion surgery.

Due to Cullison’s failure to diagnose Prager’s broken neck, the plaintiff sustained permanent C5 nerve root injuries. He underwent a second neck fusion operation and will need additional surgeries in the future, including implantation of a spinal cord stimulator to reduce pain intensity.

Prager, unable to work and largely confined to his home, decided to sue the hospital and Cullison. At trial, Cullison denied that he had failed to perform a physical exam. However, his own defense expert testified on cross-examination that if Cullison had actually performed the exam, Prager’s obvious and intense pain would have indicated that neck imaging was necessary.

The jury ruled that Cullison and the hospital had been negligent and awarded Prager $7 million in damages, plus an additional $2 million to the plaintiff’s wife for loss of consortium. The previous record-high malpractice award in Wyoming was $1.5 million.