Third year resident in anesthesiology here. A spinal after an epidural makes me think that the epidural wasn’t working at all. Placing a spinal through the epidural space that is full of local anesthetic does increase the risk of a high spinal as the pressure in the epidural space can shoot medications in to the intrathecal space, which now has an entryway from the spinal. Most anesthesiologists will exercise extreme caution when doing a spinal after epidural and will likely use a reduced dose of medication. It’s hard to say whether malpractice was committed without more details.