2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 9
E
very year, physicians perform millions of off-label epidural
steroid injections (ESI) to treat neck and back pain — despite
the risk of rare but serious and sometimes fatal neurological
side effects and despite the fact that the Food and Drug
Administration (FDA) has never approved corticosteroids for injec-
tion into the epidural space.
Off-label drug use isn't necessarily a breach of the standard of care.
The FDA considers doctors who use steroids off-label "part of the
Going Off-Label Can Cost You Big-Time
$14.9 million for patient paralyzed by epidural corticosteroid injection.
Medical Malpractice
Jerene Stremick, BSN, RN, LNC
• DANGERS OF EPIDURAL STEROIDS Bristol-Myers Squibb's Kenalog comes with a warning label against epidural use, but
physicians routinely use it off-label for neck and back pain.
