It is imperative that a physician performing a procedure knows the uses, contraindications, and adverse effects of administered medications. Hypaque is a contrast dye that is absolutely contraindicated for use in the intrathecal space. The intrathecal space is the area of the body where the spinal fluid is located, and the spinal cord and nerve roots are contained in such. Accordingly, any material placed in this space comes into direct contact with the spinal cord and exposed nerve roots. Thus, a compound unintended for use in the intrathecal space can have a toxic effect on the nervous system. The epidural space lies outside the intrathecal space, separated by thin membranes. Although the spinal nerves pass through the epidural space, they are less exposed, and thus compounds administered in the epidural space may have a less intense effect. It is clearly stated in the Hypaque package insert that “even a small amount in the subarachnoid space may produce convulsions and result in fatality.” It should never be used in any situation where inadvertent intrathecal injection can occur, as here, such as an epidural injection.
Intrathecal hypaque medical expert witness specialties include radiology, interventional radiology, neurosurgery, toxicology, and neurology.