Case #1049: Meningitis
On February 6, the 15 year old Plaintiff became ill in her school and went home early complaining of a severe headache. She was given Tylenol and was taken to the Defendants’ office that evening. Upon presentation, the Plaintiff’s Decedent was complaining of very stiff joints, aches, and a fever. Her mother had to assist her in walking to the examining room. Blood studies were completed which revealed a high white blood count of 16,600. As well, the Plaintiff’s Decedent had a fever of 103.7° in the absence of cough, chest congestion, runny nose or any abdominal complaints. The history and physical exam were performed by the Defendant’s nurse practitioner with the Defendant pediatrician conducting only a cursory observation of the patient at the end of the visit. After the nurse practitioner performed tests to elicit signs of meningeal irritation (stiff, painful neck) and found none, the Plaintiff’s Decedent was sent home with a diagnosis of probable flu. The Plaintiffs alleged that these tests were performed improperly and, in any event, the Plaintiff’s Decedent was observed to have neck stiffness.
That night, between 7:00 and 7:30 p.m., upon the advice of the Defendant pediatrician, the Decedent’s mother telephoned the Defendants’ office to inform them that her daughter had vomited on several occasions, but her earlier condition was otherwise unchanged. Notwithstanding the fact that the Defendants had previously instructed the Decedent’s mother to telephone if the Plaintiff’s Decedent experienced vomiting or any other change in signs and symptomatology, the Defendant simply advised the Plaintiff’s mother that the Plaintiff’s Decedent should remain home, and come to the office the following morning.
Accordingly, the Plaintiff arrived at the Defendant’s office the next day at approximately 9:00 a.m. By that time, she was lethargic to the point of being essentially unresponsive. 911 was called, and the Plaintiff’s Decedent was taken to the Emergency Room at a local hospital. Although antibiotics were started, they were too little and too late. After the Plaintiff’s Decedent arrived at the Emergency Room, she was promptly diagnosed with meningitis, intubated and admitted to the Pediatric Intensive Care Unit. However, despite all medical efforts, she experienced brain herniation, continued to deteriorate and died at the hospital on February 13.
The Defendant denied all allegations of negligence, contending that the Decedent show no signs of meningitis but, instead, presented with typical flu symptoms. Moreover, the Defendant contended that the Decedent contracted a fulminant bacterial meningitis which rapidly progressed on the evening of February 6 into the morning of February 7 when it was beyond successful treatment.