Delayed Diagnosis of Appendicitis Results in Ruptured Appendix

Case Overview

This case takes place in Delaware and involves a 13-year-old female with no significant past medical history. She presented to her pediatricians office with complaints of severe abdominal pain and discomfort. She was seen by a Nurse Practitioner who prescribed an adult-strength laxative, prior to ruling out appendicitis. The patient returned home and administered the laxative. Several hours later, the patient’s appendix ruptured and she was taken to the hospital. A life-threatening incident, this condition required immediate surgery to remove the appendix and clean her abdominal cavity. In addition to the immediate and acute danger, she has suffered from a host of complications as a result of the ruptured appendix.

Questions to the Pediatrics expert and their responses

Do you have any specific knowledge on the effects of prescribing an adult-strength laxative to a pediatric patient with acute appendicitis?

The laxative should have never been prescribed, and there are a number of reasons why. There are steps that should have been taken to ensure that this patient warranted a laxative - which clearly weren't taken - and since appendicitis wasn't ruled out, it was a dangerous decision to prescribe this young woman a laxative.

Is it likely that this prescription aggravated the girl’s condition?

The laxative obviously aggravated the appendix and caused it to rupture far sooner than it would have otherwise.

About the expert

This board certified expert has been practicing for over 15 years. He received his medical degree from the West Virginia University School of Medicine prior to completing residency training in pediatrics at the Medical University of South Carolina. He has been named 'Pediatrician of the Year' three times by a large, regional newspaper, and he maintains a busy private practice as a pediatrician. He is also the Chairman of Pediatrics at a major medical center.

E-007322

Specialties:

Pediatrics