Delayed Treatment of Meningitis Proves Fatal

Joseph O'Neill

Written by
— Updated on October 27, 2017

Infectious Disease Expert WitnessThis case takes place in Montana and involves a female patient who began complaining of a sore throat and an earache in the early morning. The following day, she reportedly slept most of the day and exhibited a very high fever.

Just a few days later, her fever continued and she began to display other troubling symptoms. Her mother woke her and immediately brought her to her primary care doctor’s office for the first available appointment at  that morning. During her appointment the girl was falling asleep in the doctor’s office, and she had difficulty responding to the doctor’s questions. Nevertheless, the girl was sent home from the doctor’s office with a prescription for antibiotics. By the next afternoon, she was not improving and was beginning to show signs of mental impairment. Her father immediately took her to the emergency room. She underwent a lumbar puncture, which produced  cloudy fluid – the sample later tested positive for a bacterial infection. She was immediately given Avelox and was transferred emergently to a larger medical center. However she was pronounced dead shortly after her arrival at the larger facility.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients with bacterial meningitis?
  • 2. If so, will you be able to determine if more timely intervention would have resulted in a better outcome for the patient described above?
  • 3. Have you ever served as an expert witness on a claim involving a delay in diagnosing / treating bacterial meningitis?

Expert Witness Response E-005210

I routinely treat patients with bacterial meningitis. I am an infectious diseases physician at a major hospital in Chicago, ranked in the top 10 in the nation by US News and World Report. I previously was employed at Columbia University. Based on the information given, there is a strong concern for delay in diagnosis related to her clinic appointment. Specifically, it is very unusual for a patient to be falling asleep and not responsive to questions. That combined with his high fever and other symptoms, strongly suggest she had bacterial meningitis at that time. Unfortunately, she was discharged home on oral antibiotics rather than being sent immediately to an ED. There may be other avenues to pursue to demonstrate negligence, if the chart reveals as such. A lack of performance and documentation of a proper neurological exam would have been a missed opportunity to detect meningitis earlier.  In addition, further negligence possibly could be demonstrated by absence of an adequate follow up plan, demonstrating a lack of appreciation for the severity of the patient’s symptoms.

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