Blindness Results After Woman is Denied Adequate Care

Case Overview

This case takes place in Iowa and involves a female patient who initially presented to a physician assistant complaining of chronic headaches. Five days later, the patient presented to the ER with a severe headache, which she described as feeling like her head was in a vice grip. The patient also had scotoma, blurred vision and photophobia. Five days later, the patient was seen at the ER again by another physician assistant. This time, elevated intracranial pressure was suspected and the patient was sent for a CT scan, however the scan was interpreted as within the normal limits. The patient was seen later that day complaining of difficulty balancing. The patient was discharged with Topomax and oxygen and told to follow-up in a week. One week later, the patient presented to the ER again with headache and loss of vision in the right eye, and blurred vision in the left. A CT scan was again normal. The patient was recommended for neurology and ophthalmology consultation at that point, however she was not seen by either. The patient visited the ER several times more with no resolution. After a month had passed, the patient was finally seen by a neurologist at an out-patient facility. A lumbar puncture was ordered which revealed elevated pressure, and the diagnosis of pseudotumor cerebri was made. A shunt was placed, however it was too late and the patient was left blind in both eyes.