Medicolegal Issues

Malpractice Chronicle


 

According to a published ­report, a defense verdict was returned.

Infant’s Bacterial Infection Missed

The plaintiff child, age 20 months, was brought to the emergency department (ED) with trouble breathing and a low-grade fever. The emergency physician, Dr. S., made a diagnosis of viral croup and discharged her.

The next day, the girl was brought back to the ED, where she was seen by a second emergency physician, Dr. G. Her temperature had risen to 106°F, and she had developed a croupy cough. Following administration of acetaminophen and other medications, the child’s temperature was reduced to 100°F. A test for streptococcal infection yielded negative results, and the infant was discharged.

The infant did well the following day, but that night her parents noticed that she was lethargic and breathing with difficulty. She was taken to the ED again and seen by Dr. G. This time, a diagnosis of pneumonia was quickly made, and the patient was transferred to a children’s hospital.

The child died that evening. Autopsy revealed group A streptococcal infection, which had led to toxic shock syndrome.

The plaintiff claimed that Dr. G. was negligent in his failure to diagnose the infection and to begin antibiotics when he first saw the infant. The plaintiffs claimed that the medications used included steroids, which suppressed the child’s immune system, making it more difficult for her to fight infection.

Dr. G. claimed that the infant’s presentation was inconsistent with a bacterial infection and that his diagnosis was reasonable. The defendant also claimed that the infant had an infection that would not have responded to antibiotics.

A defense verdict was returned.

Change of Procedure, Surgical Instrument Retained

In New York City, a 54-year-old man underwent a sleeve gastrectomy, performed by Dr. M. and Dr. S. Three days later, the patient was informed that a surgical tool had been left in his body, and he returned to the hospital.

CT revealed no foreign object. The patient’s large size made MRI impossible, and he was discharged. The man died three days later of peritonitis, which the plaintiff for the decedent claimed resulted from damage inflicted by a surgical instrument that had not been removed. The plaintiff claimed that the patient had consented to a Roux-en-Y bypass and had undergone presurgical preparation for that procedure, but that plan was abandoned shortly before the surgery. The plaintiff claimed that the problems resulting from the surgery performed were related to the procedure itself—specifically, that the cutting and stapling tool used in the gastrectomy had severed the esophageal stethoscope used, after which the severed remnant of the stethoscope was inadvertently stapled into the patient’s stomach.

The plaintiff for the decedent claimed that the remnant caused leakage of bile, which led to fatal peritonitis. The plaintiff claimed that the surgeons should not have concluded the surgery until it was confirmed that the stomach was properly sealed. The plaintiff also claimed that the defendants failed to address the decedent’s postsurgical symptoms of fever and severe pain.

The defendants countered that the decedent had reported no such symptoms and that there were no indications of infection. The defendants also claimed that neither CT nor intraoperative testing revealed any leakage in the decedent’s stomach. The defendants claimed that the decedent had signed a consent to undergo a gastrectomy, and that a gastrectomy had always been the intended procedure. The defendants additionally claimed that the foreign object in question was a probe, which the anesthesiologist inserted to measure the patient’s esophageal temperature without the surgeons’ knowledge.

According to a published account, a settlement of $675,000 was reached.

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