Delayed Diagnosis Of Meningitis
27 Jul 2007
A Case Review:
A teenager and her parents sued a doctor and a Longview, Texas hospital for allegedly delaying diagnosis of the girl's meningitis, which resulted in the amputation of both her legs, her right hand and the middle finger of her left hand. Elizabeth Norman, ten years old at the time, also suffered kidney and liver failure and had to have her gall bladder removed.
According to the plaintiffs, in the early morning hours of Dec. 29, 1993, Jeri Norman, Elizabeth's mother, called the Good Shepherd Medical Center and spoke with a license vocational male nurse (LVN) to see if she could bring her daughter to the emergency room. The nurse told Norman that she would have to wait five or six hours before an emergency room physician could see her daughter. The nurse suggested Norman contact her family physician.
Norman said that she attempted to contact Dr. George Marshall, the family doctor, through his answering service. When the doctor contacted Norman, she explained that her daughter was running a fever, was lethargic and was developing purple spots on her skin. Dr. Marshall allegedly told Norman to bring her daughter to the doctor's office the following morning.
Sometime between 6am and 6:30am, Norman awoke and found that her daughter's condition had worsened. Norman took Elizabeth and another daughter, Tricia, to the hospital emergency room.
It turned out that Elizabeth was one of the first victims of a meningitis epidemic that broke out in Gregg County, Texas in late 1993 and early 1994. She should have been treated immediately. Tricia had early symptoms of meningitis and according to the family's lawyer, Tricia's worsening condition was six hours behind that of Elizabeth.
Meningococcal meningitis occurs when the bacteria that causes meningitis are found in the fluid surrounding the brain and spinal cord. Meningitis is the common term used for any inflammation of the brain and spinal membrane. Symptoms commonly include high fever, weakness, severe and persistent headaches, vomiting and a skin rash which may look like small purple dots or large bruises.
Elizabeth did not spend the whole day at Good Shepherd. She was taken by helicopter to a hospital in Shreveport, Louisiana. Within days, Elizabeth was moved to Louisiana State University Medical Center and then finally to the Children's Hospital in Dallas.
Elizabeth suffered renal failure, liver failure and near cessation of her heart and lungs. She had to have her gall bladder removed and her legs, right hand and middle finger of her left hand amputated.
The plaintiffs sought actual damages in the amount of $30 million as well as punitive damages in the amount up to $30 million. The two figures include medical expenses, including special education and rehabilitation expenses, emotional distress, mental anguish, as well as loss of companionship of family.
The plaintiffs alleged that the symptoms described over the phone should have alerted the hospital and Dr. Marshall to the fact that Elizabeth had meningitis. If Elizabeth had received immediate treatment, the permanently debilitating injuries she suffered would have been minimized, according to the plaintiffs.
The defense admitted that she called the hospital, but both male nurses who worked in the emergency room the night of Dec. 29 denied talking to Norman. The hospital said there was no proof she ever talked with anyone, much less a nurse, in the emergency room.
Dr. Marshall denied that he told Jeri Norman that it would be okay to wait and bring Elizabeth to the office in the morning.
The Verdict
On June 9, 1997, the jury returned a verdict for the defense after deliberating for approximately 75 minutes. However, plaintiffs' attorney said after the verdict that Dr. Marshall's insurance company had agreed to pay Elizabeth Norman $400,000 regardless of the jury's decision.
Comments
The review of this case demonstrates the difficulty in proving to the satisfaction of a jury a breach of the standard of care in a delayed diagnosis and treatment scenario. Had the child been in the ER at an earlier point in time and improperly sent home the jury may have decided differently, however. Or, if there were more concrete documentation of the early telephone conversation that clearly showed improper advice was given, the plaintiffs may have prevailed.
It is especially difficult to prosecute a medical malpractice case involving an Emergency Room in Florida because of certain statutory immunity that has been given in many ER situations. Careful analysis of the facts of the case and the wording of the Florida Statutes is necessary to determine if there is a potential claim worth pursuing.
