We successfully defended claims against an interventional pain management specialist who performed an epidural steroid injection (ESI) in the lumbar spine for pain relief. Plaintiff underwent spinal decompression surgery eight days later and has permanent cauda equina syndrome symptoms including bowel and bladder insensitivity. At trial plaintiff claimed an MRI should have been ordered either before the ESI or in response to numerous patient phone calls after the ESI, which would have led to earlier surgery and a better outcome. The jury rejected the claims based in part on the testimony of a world-renounced interventional pain management expert that it is not and has never been standard of care to order an MRI before injections, and that our client appropriately responded to all post-injection complaints.