Epidural injections are used in several medical settings, including labor and delivery, treatment for neck or back pain, and other forms of pain management. Depending on the purpose, they may involve anesthetic medication, steroids, or both.

Complications can occur even when an epidural is performed correctly. But preventable mistakes involving needle placement, dosage, monitoring, infection control, or delayed treatment may support a malpractice claim. Shebell & Shebell’s medical malpractice attorneys in New Jersey can review what happened and help determine whether negligent care played a role.

What is an Epidural Injection?

An epidural injection delivers medication into the epidural space around the spinal cord and nerve roots. It may be used to provide anesthesia, reduce pain, or decrease inflammation.

Epidurals During Labor and Delivery

During childbirth, epidural anesthesia is commonly used to reduce pain while allowing the mother to remain awake.

A catheter is usually placed near the spine so medication can be delivered continuously or as needed. Maternal blood pressure, heart rate, breathing, and other vital signs should be monitored, and fetal monitoring may also be required.

Epidural Steroid Injections for Pain Management

Epidural steroid injections may be used to reduce inflammation around irritated spinal nerves.

They are commonly associated with conditions such as:

• Neck pain
• Lower back pain
• Sciatica
• Radicular pain
• Herniated-disc-related symptoms

These injections may be performed in the cervical, thoracic, or lumbar spine depending on the condition being treated.

Other Uses

Epidural anesthesia or analgesia may also be used during certain surgical procedures or for postoperative pain control.

What is Epidural Injection Negligence?

Epidural injection negligence occurs when a healthcare provider fails to meet the accepted standard of care during the administration, monitoring, or management of an epidural and that failure causes injury.

The negligence may involve the provider who performs the injection, another member of the anesthesia team, nursing staff, or other healthcare professionals responsible for monitoring and follow-up care.

A Complication Is Not Automatically Malpractice

Not every bad outcome after an epidural means malpractice occurred.

Some complications are recognized risks even when the procedure is performed correctly. The legal question is whether the injury resulted from a preventable error, such as improper placement, incorrect medication, failure to monitor the patient, or failure to respond appropriately when a complication developed.

Some preventable medical errors are considered especially serious; see our guide to never events and preventable medical errors.

Common Examples of Epidural Negligence

Epidural negligence can occur before, during, or after the procedure.

Improper Needle or Catheter Placement

An epidural needle or catheter must be positioned carefully around sensitive nerves and spinal structures.

Potential errors may include:

• Placing the needle in the wrong location
• Advancing the needle too deeply
• Damaging a nerve
• Injuring the spinal cord
• Incorrectly positioning the catheter

Improper placement may cause immediate symptoms or injuries that develop after the procedure.

Wrong Medication or Dosage

Medication errors can also cause serious complications.

Examples include:

• Giving too much medication
• Giving too little medication
• Using the wrong drug
• Using the wrong concentration

An incorrect dose may lead to inadequate pain control or more serious problems involving blood pressure, breathing, or neurological function.

Failure to Review Medical History or Contraindications

Healthcare providers should review whether an epidural is appropriate for the individual patient.

Important considerations may include:

• Blood-thinning medication
• Bleeding disorders
• Low platelet counts
• Existing infection
• Medication allergies

Failing to identify a condition that increases the risks of an epidural may contribute to preventable harm.

Failure to Monitor the Patient

Monitoring is especially important after an epidural because complications may appear gradually.

Depending on the setting, providers may need to monitor:

• Blood pressure
• Heart rate
• Breathing
• Oxygen levels
• Neurological changes
• Response to medication

During labor and delivery, fetal monitoring may also be necessary.

Failure to properly monitor a patient can also involve broader nursing errors; learn more in our guide to nursing negligence.

Failure to Recognize or Respond to Complications

Even when a complication was not preventable, failing to respond appropriately may create a separate problem.

Warning signs may include:

• Weakness
• Numbness
• Severe headache
• Fever
• Difficulty breathing
• Severe or worsening back pain
• Loss of bladder or bowel control

Delays in recognizing these symptoms can allow an otherwise treatable complication to become more serious.

Infection-Control Errors

Epidural procedures require careful infection-control practices.

Potential negligence may involve:

• Unsterile technique
• Contaminated equipment
• Improper skin preparation
• Failure to recognize signs of infection afterward

Infections near the spine can become dangerous quickly if diagnosis or treatment is delayed.

Lack of Informed Consent

Patients should generally be informed about the nature of the epidural, significant risks, and reasonable alternatives before the procedure.

A failure to obtain proper informed consent may become relevant when a patient was not adequately informed before undergoing treatment.

What Injuries Can Epidural Errors Cause?

The severity of an epidural injury can vary widely.

Potential complications may include:

• Nerve damage
• Chronic pain
• Numbness
• Weakness
• Paralysis
• Spinal cord injury
• Post-dural puncture headache
• Cerebrospinal fluid leak
• Epidural hematoma
• Infection
• Epidural abscess
• Meningitis
• Low blood pressure
• Respiratory problems
• Allergic reactions
• Seizures
• Cardiac arrest
• Death

When a medical error results in death, surviving family members may also want to understand who can file a wrongful death or survivorship lawsuit in New Jersey.

Epidural Hematoma and Infection

An epidural hematoma occurs when bleeding develops near the spinal cord or surrounding structures. If pressure builds, neurological symptoms can worsen quickly and emergency treatment may be necessary.

Infections such as an epidural abscess can also become serious when they are not recognized early. Delayed treatment may increase the risk of nerve damage, spinal cord compression, or other complications.

Nerve and Spinal Cord Injury

Nerve or spinal cord injuries may result from direct trauma, improper needle placement, bleeding, infection, or pressure on neurological structures.

Symptoms can range from temporary numbness or weakness to chronic pain, loss of function, or permanent paralysis in severe cases.

Epidural Negligence in Different Medical Settings

Epidural negligence can occur in childbirth, pain management, surgery, and other settings where medication is delivered near the spine.

During Labor and Delivery

Epidural anesthesia during childbirth requires careful placement, appropriate dosing, and continued monitoring of both the mother and baby.

Providers may need to watch for:

• Sudden blood-pressure changes
• Breathing problems
• Abnormal medication reactions
• Maternal distress
• Changes in fetal heart rate
• Signs that emergency intervention is necessary

Errors may involve improper needle or catheter placement, incorrect dosage, inadequate monitoring, or delayed response when the mother or baby shows signs of distress. Epidurals are commonly used during labor, but proper maternal and fetal monitoring remains important throughout the process.

Epidural Steroid Injections for Pain Management

Epidural steroid injections are also used to treat conditions involving neck, back, and radiating nerve pain. These procedures may involve injections into the cervical or lumbar spine.

Potential errors can include:

• Improper needle placement
• Inadequate imaging guidance when appropriate
• Direct nerve or spinal cord injury
• Wrong medication or dosage
• Infection
• Epidural hematoma
• Failure to recognize neurological symptoms afterward

Because these injections occur close to sensitive nerves and spinal structures, proper technique and follow-up monitoring are important. Competitor guidance also recognizes epidural steroid injections as a use separate from childbirth, including treatment for severe neck, lumbar, and leg pain.

Repeated or Unnecessary Injections

Receiving multiple epidural injections does not automatically mean negligence occurred.

However, questions may arise when injections are performed without an appropriate medical reason, repeated despite serious complications, or continued when the patient is showing signs that further treatment may be unsafe.

When Does an Epidural Injury Become Medical Malpractice?

An epidural injury may become the basis of a medical malpractice claim when a healthcare provider departs from the accepted standard of care and that mistake causes harm.

Standard of Care

The applicable standard of care may involve:

• Properly evaluating the patient beforehand
• Correct needle and catheter placement
• Selecting the appropriate medication and dosage
• Using proper sterile technique
• Monitoring the patient
• Recognizing complications
• Responding to emergencies in a timely manner

Not every complication means that this standard was violated. The circumstances surrounding the procedure must be evaluated.

Causation

It is not enough to show that a mistake occurred.

The patient must generally establish that the provider’s negligence contributed to the injury. This can become especially important when the underlying condition or a recognized complication could also explain the patient’s symptoms.

Who May Be Responsible?

Responsibility depends on who participated in the patient’s treatment and what went wrong.

Potentially responsible parties may include:

• An anesthesiologist
• A CRNA or nurse anesthetist
• A pain-management physician
• An obstetrician
• A hospital
• An ambulatory surgical center

More than one provider or facility may become relevant when the injury involves failures in placement, medication administration, monitoring, supervision, or emergency response.

For another example of how a preventable procedural mistake can lead to malpractice, read our guide to wrong-site surgery.

Proving Epidural Injection Negligence in New Jersey

Epidural malpractice cases often depend heavily on the medical record and review by qualified medical professionals.

Important Evidence

Evidence may include:

• Procedure notes
• Anesthesia records
• Medication records
• Imaging used during the procedure
• Consent forms
• Vital-sign records
• Nursing notes
• Fetal monitoring strips when relevant
• Follow-up treatment records
• MRI or other imaging after the injury

These records can help establish what happened before, during, and after the epidural.

Medical Expert Review

A medical expert may be needed to evaluate:

• The applicable standard of care
• Whether the provider departed from that standard
• Whether the departure caused the patient’s injury

New Jersey medical malpractice cases also generally involve an Affidavit of Merit from an appropriate licensed professional stating that there is a reasonable probability the care fell outside acceptable professional standards. New Jersey law generally requires the affidavit within 60 days after the defendant files an answer, with one additional period of up to 60 days potentially available for good cause.

Potential Damages

Depending on the severity of the injury, damages may include:

• Additional medical treatment
• Hospitalization
• Rehabilitation
• Future medical care
• Lost wages
• Reduced earning ability
• Pain and suffering
• Disability
• Permanent neurological injury

The damages available depend on the specific injuries and losses caused by the negligent care.

What Should You Do After a Suspected Epidural Injury?

Certain symptoms after an epidural deserve prompt medical attention, particularly when they are new, severe, or worsening.

Seek Medical Attention

Symptoms that may require evaluation include:

• Weakness
• Numbness
• Severe headache
• Fever
• Difficulty breathing
• Loss of bladder or bowel control
• Worsening neurological symptoms

Seeking treatment is important both for protecting the patient’s health and documenting what occurred.

Request Medical Records

Patients should consider obtaining records related to the procedure and subsequent treatment.

These may include the epidural procedure report, anesthesia records, medication records, imaging, nursing notes, monitoring records, and follow-up care.

Document Symptoms and Timing

Write down when symptoms began and how they changed.

Useful details may include:

• When the symptoms first appeared
• Whether they became progressively worse
• Who was notified
• What treatment was provided

A clear timeline can help medical professionals and attorneys understand whether a complication was recognized and treated appropriately.

Frequently Asked Questions About Epidural Negligence

What Is Epidural Injection Negligence?

Epidural injection negligence occurs when a healthcare provider fails to meet the accepted standard of care during an epidural procedure and that failure causes injury.

Can an Epidural Cause Permanent Nerve Damage?

In rare cases, complications involving direct nerve trauma, spinal cord injury, bleeding, infection, or compression can result in lasting neurological damage.

Is a Bad Epidural Automatically Malpractice?

No. Some complications can occur even when an epidural is performed correctly, so malpractice depends on whether negligent care caused or worsened the injury.

Can Epidural Negligence Happen Outside of Childbirth?

Yes. Epidural injections are also used for pain management, including cervical and lumbar epidural steroid injections for neck, back, and radiating nerve pain.

Can a CRNA Be Responsible for an Epidural Error?

Potentially. A CRNA or nurse anesthetist may be involved in administering anesthesia, medication dosing, monitoring, or recognizing complications, depending on the medical setting.

What Evidence Is Used to Prove Epidural Malpractice?

Evidence may include procedure records, anesthesia notes, medication records, vital signs, imaging, nursing records, monitoring data, and medical expert opinions.

Conclusion

Epidurals are used during childbirth, pain-management procedures, surgery, and other medical treatment. Complications can occur without negligence, but improper placement, medication errors, inadequate monitoring, infection-control failures, or delayed treatment may cause preventable injuries.

If you believe an epidural error caused serious harm, Shebell & Shebell’s medical malpractice attorneys in New Jersey can review the medical records, determine what happened, and explain your legal options.