High school senior dies after doctors botch diagnosis and treatment of acute disseminated encephalomalacia (ADEM)

As a Houston, Texas medical malpractice lawyer, every day my law firm hears tragic stories from clients about how lives were changed or ended because of poor medical care.

This week, we met with new clients about a terribly sad situation. Let me tell you their story.

One morning, the parents of a Houston-area high school senior found her on the floor in a room, nauseated and unable to get up or walk. She started vomiting a lot and told her parents that she was too weak to move. They called an ambulance, which took her to a nearby hospital.

They waited for over two hours at the emergency room before being seen. During that time, the young lady started becoming incoherent and talking incoherently. The emergency physician who eventually saw her suggested that she had the flu.  All the lab work came back normal, though. The young lady's parents questioned the ER doctor about the explanation for her sudden inability to speak normally. He suggested that she was faking it and probably just seeking attention.

The concerned parents did not let up on the emergency room doctor, so he eventually agreed to admit her to the hospital. The nursing staff took her to a regular floor room and started an intravenous line (IV). They came back to try to test her for meningitis, but said that they could not do so because they could not find any cerebrospinal fluid (CFS). There was no physician follow-up on this concerning problem.

Later that evening, this young patient stopped talking and seemed to drift off to sleep. The nursing staff tried to wake her repeatedly to administer medications, but she was nonresponsive. The nurses even tried shaking her and pounding on her chest to wake her up, but all the patient would do is take deep breaths. She remained in this state for two days, but her family never saw a doctor come in to  evaluate her.

Finally, late in the afternoon of her third day in the hospital, a neurologist came by to assess this patient. It took him just seconds to figure out that something was gravely wrong. He ordered an immediate transfer to the intensive care unit (ICU) and a stat (as soon as possible) MRI scan. The hospital’s MRI scanner was broken, though, so the order was modified into a CT scan.

When the MRI machine was repaired, a scan showed that this young patient had experienced multiple strokes and had brain damage. A neurosurgeon visited the young lady’s room and told her family that she would need surgery to reduce swelling in her brain.

Twelve days after her parents brought her to the hospital, this precious young lady died. The death certificate shows the main cause of death as acute disseminated encephalomalacia.

Acute disseminated encephalomalacia

The National Institute of Neurological Disorders and Stroke defines acute disseminated encephalomalacia (ADEM) as a quick, widespread attack of inflammation in the brain and spinal cord that damages the protective covering of nerve fibers, called myelin.

ADEM symptoms often appear suddenly, beginning with things like fever, fatigue, headache, nausea, and vomiting. The condition is more common in children than adults.

The standard of care requires physicians to order diagnostic imaging, like an MRI scan, to search for potential areas of brain damage. 

If untreated, ADEM damages the white matter of the brain, leading to neurological symptoms including visual loss in one or both eyes, weakness or paralysis, and difficulty using muscles, such as in walking.

With proper treatment of anti-inflammatory drugs, though, most people recover. A common treatment includes several days of intravenous corticosteroids followed by oral corticosteroids. In severe cases, and in those patients for which corticosteroids do not work, other treatments may be necessary.

Experts have found that most patients who receive proper treatment begin to recover in a few days. Within six months, the majority of patients properly diagnosed and treated for ADEM have total or near-total recoveries.

We are here to help

If you or a loved one has been seriously injured by misdiagnosis and medical malpractice, call the experienced lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.


Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who sues hospitals, doctors, surgeons, anesthesiologists, and other healthcare providers on behalf of his clients. He has been honored by Martindale Hubbell with the prestigious AV designation and, in 2017, was recognized as one of Houston’s top lawyers by H Texas magazine.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.