As a Houston, Texas medical malpractice lawyer, I have represented many clients who went to the doctor or hospital several times with the same medical problem, only to be turned away. In my experience, this often happens when a doctor, physician assistant, or nurse practitioner rushes to a conclusion, rather than doing a full workup of all possible causes of the condition or illness.
A case involving a baby boy shows how dangerous this poor practice of healthcare can be to patient safety.
The mother of an 11-month-old little boy took him to a hospital emergency room for three days in a row with the same symptoms, which were getting progressively worse.
The first day, the baby had been fussy and had a fever for several days. He was quickly diagnosed with an upper respiratory tract infection and discharged.
The next day, the mother returned to the emergency room because her baby had an even higher fever, was breathing quickly, and had a rapid heart rate. The emergency providers discharged him again without doing any further workup.
On the third and final day, they returned to the emergency room and were seen about an hour after arriving. The emergency providers ordered lab work this time, but was not completed for several more hours. He was eventually diagnosed with bacterial meningitis, and it took another three hours before they started antibiotics.
Bacterial meningitis
Bacterial meningitis is never a diagnosis that you want to hear. In an average year, there are 4,100 cases and 500 deaths in the United States from bacterial meningitis. Death can happen in as little as a few hours.
While most people recover from meningitis, survivors can be left with serious, permanent disabilities, including brain damage, learning disabilities, and hearing damage.
The major types of bacteria that cause meningitis in the United States include Streptococcus pneumoniae, Group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.
According to the Centers for Disease Control and Prevention, the signs and symptoms to be aware of for bacterial meningitis include a stiff neck, fever, headache, nausea, vomiting, sensitivity to light (photophobia), and confusion (altered mental status). While many of these symptoms are somewhat generic to other illnesses, early diagnosis, through lab work of blood or cerebrospinal fluid, is important to get treatment started quickly.
There are three general factors that increase the risk for contracting bacterial meningitis. First, is age. While people of any age can develop bacterial meningitis, babies are at a heightened risk. Second, travel to certain areas in Africa. Third, people who live on college campuses or other places where large groups of people get together have an increased risk.
Now, for the rest of the story about the little boy I discussed above. He survived bacterial meningitis, but was left with a brain injury that has caused delay development and neuro- cognitive disabilities. The emergency room providers had three separate days to make the correct diagnosis and, even on the third day, delayed the necessary life-saving treatment.
While I believe that there was ample information for the emergency room staff to make the correct diagnosis and treatment for a patient of any age, they should have taken more time, ordered more tests, and shown more care when it came to an infant.
American College of Emergency Physicians recommendations
The American College of Emergency Physicians issued a policy in 2003 called the “Clinical Policy for Children Younger Than Three Years Presenting to the Emergency Department With Fever.”
This document starts with the observation that fever is one of the most common presenting complaints of children and infants in an emergency room setting. Emergency physicians must confront the challenge of telling the difference between the majority of pediatric patients with a fever who will have an uneventful course, from the fewer number of patients who have serious infections that require emergency diagnosis and treatment.
The policy document has several significant recommendations. For example, infants between 1-28 days old with a fever should be presumed to have a serious bacterial infection. Children less than a year-old with a fever, without a source, should be considered at risk for a urinary tract infection.
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If you or a loved one has been seriously injured because of medical malpractice, call the experienced attorneys at Painter Law Firm, at 281-580-8800, for a free consultation about your potential case.
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Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, doctors, surgeons, anesthesiologists, and other healthcare providers. He frequently writes and speaks about topics related to healthcare and medical malpractice. He was previously editor-in-chief of The Houston Lawyer magazine and currently serves on the editorial board of the Texas Bar Journal.
