$10M Verdict After ER Doctors Canceled MRI and Missed Spinal Abscess for 17 Hours

In December 2021, John Douglas Cox, then 62, arrived at the PeaceHealth Southwest Medical Center emergency department in Vancouver, Washington, with symptoms consistent with a rapidly worsening spinal infection. Cox had recently received an implanted spinal cord stimulator, and he was developing signs of a spinal epidural abscess, a bacterial infection that pools around the spinal cord and can cause permanent paralysis within hours if not surgically decompressed.

The physicians assigned to Cox that afternoon, Dr. William Loker and Dr. Gregory Hoskins, faced a complication: Cox's Kaiser Permanente Northwest doctor was unavailable to confirm the MRI-compatibility specifications of his implanted stimulator device. Rather than escalating to the device manufacturer or pursuing alternative authorization pathways, Hoskins canceled the thoracic MRI that had already been ordered. In its place, the doctors ordered a CT imaging study. The CT report came back hours later and made no mention of the abscess. Cox sat in the emergency department for close to 17 hours as his paralysis advanced. Surgery was not performed until more than 27 hours after he arrived.

Cox and his wife Cherri filed suit against the two PeaceHealth emergency physicians. The case, docketed in Multnomah County Circuit Court as case 23CV40984, centered on the decision to cancel the MRI and substitute an imaging study that was not capable of ruling out a spinal epidural abscess. Jane Paulson of Paulson Coletti Trial Attorneys represented the Coxes at trial.

Paulson argued that the standard of care required the physicians to obtain MRI imaging or, if that route was genuinely blocked, to treat the clinical presentation as a spinal emergency and transfer Cox to a facility that could image him. The defense contested causation, but the jury found the care provided fell below the standard.

In March 2026, the jury returned a $10 million verdict, allocating $8 million to John Cox and $2 million to Cherri Cox for her loss-of-consortium claim. The jury assigned 80 percent of fault to Kaiser Permanente Northwest, which was not a party at trial, and 20 percent to the two PeaceHealth physicians. Under Oregon comparative-fault rules, the 20 percent share attributable to the named defendants means each physician owes approximately $1 million. No post-trial reduction or remittitur has been reported. Cox remains partially paralyzed.