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$150,000 Settlement for Medical Malpractice - Failure to Diagnose Diverticulitis

In late 1996 and early 1997, the plaintiff, a 27-year-old male, began to experience bouts of abdominal pain. The pain was fairly mild and the plaintiff did not have a fever. The plaintiff was seen in the emergency department on Jan. 1, 1997, and discharged with a diagnosis of gastritis.

In the latter part of January 1997 and on into early February, the plaintiff continued to have some occasional pain, loss of appetite and occasional diarrhea.

On February 15, 1997, the plaintiff sought treatment at a federally funded urgent care clinic. The physician who saw him noted that the plaintiff had a non-tender abdominal examination, upper respiratory tenderness in the sacral region of the back and a temperature of 103.3. The physician further noted that the plaintiff had been having unprotected sexual relations for the past year. The physician recorded a diagnosis of "rule out STD" (sexually transmitted disease) and she gave the plaintiff one dose of an antibiotic in the office, Ceftriaxone, and a prescription for another antibiotic, Doxycycline. The physician testified that she chose the Ceftriaxone and Doxycycline to cover the plaintiff for either an STD or an upper respiratory infection. The physician also advised the plaintiff to follow up with his primary care physician.

The plaintiff was discharged from the clinic, and his condition worsened significantly overnight. The following afternoon, on Feb. 16, the plaintiff collapsed in the bathroom. An ambulance was called and the plaintiff was transported to a hospital emergency department. The plaintiff was seen by a surgeon who found guarding and rebound tenderness on abdominal examination as well as rectal tenderness. The plaintiff was taken to the operating room for exploratory surgery for what was thought to be appendicitis.

Surgery, however, revealed diverticulitis with a ruptured colon. The plaintiff required resection of the damaged area and sigmoid colostomy. Following surgery, the plaintiff developed complications, including sepsis and respiratory distress syndrome. He was hospitalized for some weeks and thereafter required care in a rehabilitation center.

The plaintiff was unable to work for some eight months, required surgery to reverse the colostomy, and suffered neck and chest scarring as a result of the various treatments. The plaintiff's expert was expected to testify that given the plaintiff's presentation at the hospital emergency department, the plaintiff's abdominal examination could not have been normal 24 to 48 hours earlier, an abnormal abdominal examination required further workup and that further workup would have revealed the plaintiff's condition.

The defendant's expert agreed that further workup would have been required if the plaintiff's abdominal examination was abnormal. The defendant's expert opined, however, that the medical records documented a careful and thorough abdominal examination, which was normal; diverticulosis and/or diverticulitis is highly unusual in a young adult and would not typically be considered in the differential of a young adult; and, accordingly, it was appropriate to prescribe oral antibiotics and to follow up with the patient's primary care physician.

The case settled at mediation.

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