Case #4011 Misdiagnosis of Septic Shock
On April 3, the Minor Plaintiff, a 14-year-old male, presented to the Defendant’s office with complaints of fever, body aches, pain and a harsh cough. He was seen by the Defendant who was a physician assistant. After a cursory examination, the Defendant PA diagnosed the Minor Plaintiff with an “influenza-like illness” and discharged him with instructions to resume regular activities on April 7.
On April 5, the Minor Plaintiff returned to the Defendant’s office because he had not improved. He was again seen by the Defendant PA. Laboratory work revealed a white blood cell count of 6.6 with neutrophils of 91.3 — representing a left shift indicative of infection. Additionally, blood was detected in the Minor Plaintiff’s urine — a significantly abnormal finding and one which is not found with influenza. The Minor Plaintiff was additionally tachycardic and had a previously completed nasal swab at the Defendant institution two days earlier which was negative for influenza A and B.
Notwithstanding all of these findings, the Defendant PA negligently continued to diagnose the Minor Plaintiff with a non-resolving influenza — when, in fact, he had no influenza, but suffered from a serious infection which required appropriate diagnosis and treatment in conformity with the standards of care. Tragically, the Defendant PA negligently discharged the Minor Plaintiff again, advising the Plaintiffs to follow-up in three days if the Minor Plaintiff was not feeling better.
On April 7, at approximately 5:46 a.m., 911 was called because the Minor Plaintiff was having difficulty breathing and was suffering with severe, generalized weakness. At the hospital, he was immediately diagnosed with septic shock and intravenous fluids were instituted. Laboratory work revealed a white blood count of 3.62 — indicative of cold sepsis with bands of 27 (extremely elevated), platelets of 44 (extremely low), and a pH of 6.98 (indicative of acidosis), with positive cultures for Methicillin-resistant Staphylococcus aureus (MRSA) — an infection which should have been timely diagnosed by the Defendant and treated appropriately.
Ultimately, due to decreased circulation in his lower extremities, the Minor Plaintiff required a right below-the-knee amputation and suffered a left foot drop. He remained confined at that hospital for approximately 2 months before being transferred to a rehabilitation institute. Subsequently, the Minor Plaintiff required a prosthesis in an attempt to restore some form of ambulation. Additionally, he requires a brace to attempt to stabilize his left foot drop.
Had the Defendant conformed with the applicable standards of care, the Minor Plaintiff would have returned to his home and family to resume all of his normal activities with no deficits whatsoever.