Samantha Shatz shares insights on her chosen specialization and the nuances of cauda equina syndrome
This article was created in partnership with Howie Sacks & Henry LLP
From the beginning of her legal career, Samantha Shatz had a keen interest in health law. When named partner, Neil Sacks, asked Shatz almost five years ago to work alongside him in the area exclusively, she jumped at the chance to access his decades of experience in medical negligence and birth injury litigation. Now one-half of the firm’s specialized team that focuses on obstetrical negligence and spinal cord injuries, Shatz feels she’s in the best place to grow in the practice area.
“Howie Sacks & Henry LLP has an excellent reputation, and there are only a small number of lawyers in Ontario whose focus is on medical negligence law, which involves highly complex and nuanced work,” says Shatz, now a senior associate at the firm. “Learning one-on-one from Neil who has such a wealth of knowledge has been truly incredible.”
It takes specific expertise to handle medical negligence cases and a commitment to learning the medicine. “It’s not the type of practice where you can have one foot in, and one foot out.”
The firm has established great working relationship with defence counsel and built an extensive network of high-level experts in various fields of medicine.
The team knows who to consult with to assess each case, determine if it’s viable, and if so, provide the expert testimony to support a client’s claim. Working closely with these medical professionals is something Shatz loves most about her role.
“I learn so much from incredible doctors and nurses who work at the top hospitals and help people every day, and it’s remarkable to be able to collaborate with them,” she says. Furthermore, “It’s not just about the medical records, you must also keep on top of medical journals and other literature that could impact your case. You need to know these cases inside and out.”
The medical malpractice group at Howie, Sacks & Henry LLP, handles a number of spinal cord related cases, many of which involve the delayed diagnosis of cauda equina syndrome (CES). CES occurs when the bundle of nerves at the base of the spinal cord becomes compressed. It’s a medical emergency and if left untreated, it can result in catastrophic consequences, such as paralysis.
Individuals typically present to the emergency room with red-flag symptoms which can include, severe lower back pain, incontinence, and bilateral numbness in the legs. Early identification of CES is crucial and while an MRI imaging is the gold standard for diagnosing the condition, many community hospitals lack immediate access to those machines.
The biggest challenge is often the causation aspect, Shatz explains. The main question is, had the person been diagnosed and treated in a timely manner, would their neurological damage have been avoided?
“We often have to pin down the cases hour by hour,” she says. “Had CES been flagged and a referral for an MRI been made, when would the MRI have been completed? There are a lot of puzzle pieces to fit together.”
Through years of experience with spinal cord injury patients, they’ve also developed a roster of experts, such as occupational therapists who visit clients’ homes to evaluate every aspect of their daily lives and what future care looks like for them. With a wide range of clients including those who are quadriplegic and paraplegic, each case, person, and situation is unique and assessed individually.
However, obtaining the care clients need is a challenge. Many of these clients require extensive daily support, from personal support workers to occupational therapy, and nursing care, but the reality is that government services such as those offered through Home and Community Care Support Services (HCCSS) are often understaffed, and patients only get a few hours of care per week. Private care is easier to access, but it’s expensive, and can be difficult to maintain long-term.
Aside from achieving justice for clients, it’s also important to educate the public about spinal cord injuries. CES, for example can result from something seemingly small like a low impact fall or something more serious like a disc herniation or infection.
“People need to advocate for themselves in the ER, or have someone advocate on their behalf, because once the damage is done, it can often be irreversible. We’re committed to spreading awareness about it.”
