Nurse Practitioner Fails to Diagnose Advanced Thyroid Cancer

Are you capable of determining if there was deviation from the standard of care?

Clinically; when there is a lack of clinical response to empiric treatment for a soft tissue infection the clinician may opt in treatment in a patient without risk factors, to change to an antibiotic which would treat MRSA if suspected or other regional resistant strains of commonly occurring bacteria. If there is a resulting lack of clinical response, or there are systemic symptoms, a thorough evaluation and consultation or referral is the standard of care. In this case, however, the patient was a diabetic which increased his risk status for infectious complications and also had Hepatitis C, with the possibility of immunosuppressive treatment. As this patient remained symptomatic despite treatment, a thorough evaluation including possible hospitalization, depending on the severity of the infection and systemic symptoms, as well as consultation and/or referral, depending on the nature of the infection, and resources available was the standard of care. One is not able to comment beyond the fact that the patient had a lack of clinical response to antibiotic treatment, and it does not appear that the patient received a timely thorough evaluation and consultation with either an ID specialist in the case of infection, or ENT in case of persistent difficulty swallowing and residual neck pain.