Spinal Fracture Case Settles for 6-figure Sum

Jodi Newton

Spinal Fractures following cessation of Denosumab injection

Case Overview

Stephanie Prior was instructed in a spinal injury claim against Mid and South Essex NHS Foundation Trust, where our client suffered multiple spinal fractures after discontinuing her Denosumab injections.

Medical Background

Our client was diagnosed with osteoporosis in November 2011. A Dexa scan in October 2013 confirmed osteoporosis in her spine and osteopenia in her hip. Thereafter, in November 2013, she was having prolia injections for osteoporosis. In May 2014, she was given Denosumab injections.

Complication due to Rheumatoid Arthritis

Our client was diagnosed with Rheumatoid Arthritis in October 2016. In September 2017, our client had a considerable Rheumatoid Arthritis flare up and was bed-bound for 3 days and off work for 2 weeks. Thereafter, she was regularly seen by Dr Emese Balogh, Consultant Rheumatologist, at Broomfield Hospital and had many DEXA Frax scans. Her Denosumab injections continued at her GP surgery every 6 months.

Denosumab Discontinued

On 19 March 2019, she was seen by Dr Emese Balogh, who decided to discontinue her Denosumab. This was against the NICE guidelines, which state that anyone receiving Denosumab should plan on continuing Denosumab for life, with regular monitoring and internal reviews. There is no recommendation in the guidance to stop Denosumab treatment.

Resulting Injuries

As a result of the decision to discontinue Denosumab, our client suffered multiple vertebral fragility fractures at T12, L1, L2, L3 and L4. The fractures were first diagnosed 10 months after Denosumab was discontinued. Our client is now under the care of Dr Ken Poole, Consultant Rheumatologist and Metabolic Bone Physician. Dr Poole is of the opinion that the likely date of the first fracture was 10 October 2019, when our client was working lifting and bending as part of her duties as a science assistant in a school. Dr Poole is of the view that our client suffered rebound Denosumab cessation vertebral fractures.

Our client has had irreversible changes to her five vertebrae from T12 down to L4. The fractures have led to considerable changes in the mechanics and posture of her back. Our client has lost height and she has lost the normal curvature of her spine, in that her thoracic spine and lumbar spine are very straight causing restrictive movement. She also has reduced stability and has had a number of falls since the incident, resulting in her having to take time off work.

Impact on Daily Life

This has had a significant effect on her life. Our client is employed as a Science Technician at a secondary school. She is still able to continue working, although this has been modified. Although our client remains largely independent, she requires assistance with housework, particularly in the kitchen. She cannot do her gardening, which used to be her main hobby and source of enjoyment. This has all had a significant impact on her mental health.

Settlement

Stephanie Prior successfully settled the claim for a six-figure sum without the need to issue Court proceedings, as the Defendant Trust admitted liability following the Letter of Claim.

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