This case involved a 72–year–old male patient with a history of degenerative disc disease, kyphosis, and ankylosing spondylitis with fusion of C2–C6. The patient was involved in an MVA and transported to the hospital with multiple abrasions, bruises, and complaints of lower extremity weakness. X-rays and CT revealed a C6–7 subluxation with a jumped facet on the right side and a mild L3 compression fracture. It was unclear if the subluxation was new or chronic. Later, the patient began to develop numbness in his hands and was unable to move his right arm. The defendant noted the patient had significantly declined from what he described when he arrived in the ER and was complaining of some numbness all the way up to his nipple line on the left side only and that his left leg was weak. A STAT MRI showed a 2 cm long cord contusion at the C7 level with a tear of the anterior longitudinal ligament, an interspinous ligament tear at C6–7, and stretching of the posterior longitudinal ligament. The patient was put on steroids and emergently transferred to another facility where he underwent an emergency fusion procedure. Unfortunately, he was left with quadriplegia and died a few months later due to complications of quadriplegia.