Case #1051: Rheumatic Fever
On November 21, the 41 year old female Plaintiff presented to the Defendant primary care physician with symptoms of a fever, chills, and fatigue. She had been a patient of the Defendant since approximately 2005. She had a history of rheumatic fever and a heart murmur of which the Defendant was aware. The Defendant simply diagnosed the Plaintiff with an upper respiratory infection and provided Amoxicillin for the signs and symptoms. No cultures or other sensitivity studies were obtained to determine what antibiotic was appropriate to treat her condition.
The Plaintiff returned to the Defendant on December 12, and then into the next year on January 17, April 6, May 7 and May 11, with recurrent complaints similar to those of her previous multiple visits. The Defendant repeatedly failed to perform the necessary blood cultures and/or other blood work, and simply prescribed Amoxicillin, Levaquin, and gave an allergy shot. Additionally, for all of the Plaintiff’s visits, the Defendant negligently failed to monitor her heart murmur in view of her history and ongoing fever of undetermined origin.
The Plaintiff alleged that in light of her history of rheumatic fever and heart murmur, the standards of care required the Defendant to perform blood cultures to identify the offending bacteria, and monitor the Plaintiff’s cardiac status — particularly her heart valves. Individuals who have suffered rheumatic fever with resultant heart murmurs, are more vulnerable to infections and, if not properly treated, endocarditis.
Predictably, on May 15, the Plaintiff collapsed and was taken to a hospital. There, a 2D echocardiogram confirmed that she developed bacterial endocarditis. She required placement of an intra aortic balloon pump to stabilize her cardiac condition followed by admission to the cardiac intensive care unit. Subsequently, the Plaintiff underwent a head CT scan which revealed a large infarct. The Plaintiff underwent neurosurgery for evacuation of a clot in her brain, and was subsequently operated upon for a replacement of her mitral valve, which was destroyed by the bacterial endocarditis.
The Plaintiff has been left brain injured and wheelchair bound as the direct and proximate result of the negligence of this Defendant. She was 41 years of age, married and employed when the negligence occurred. As the result of the negligence, she will be dependent upon others for the remainder of her life. She will require hospital, surgical, physiotherapeutic, nursing, custodial and other care, on a permanent basis and cannot return to her job.