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Pediatric Otolaryngologist Discharges Fatally Ill Patient

Joseph O'Neill

Written by
— Updated on October 27, 2017

Pediatric OtolaryngologyThis case takes place in Michigan and involves a male child who was born with a laryngeal cleft that had been repaired when he was a toddler. As a result of the defect and subsequent repair, the patient had endured multiple bouts of pneumonia and other respiratory infections throughout childhood, causing worry that he may be susceptible to Legionella bacteria and other medical threats. On one occasion, the patient’s mother brought him to the emergency room after he began to demonstrate shortness of breath and wheezing while in school. He was admitted and received an ENT consult shortly afterwards. While the patient was in the hospital, his oxygen levels were noted to be low by the attending physician. The patient’s mother also reported to the ENT that he had been having trouble swallowing in the days leading up to the ER visit. Initially there was concern that the child had suffered lung damage from the use of baby powder. The ENT recommended that endoscopy be performed in a few weeks, and discharged the child on oxygen. A few days later the patient collapsed at home. He was rushed to hospital but was dead on arrival. The autopsy revealed aspiration pneumonia as the cause of death.

Question(s) For Expert Witness

  • 1.) Do you routinely treat patients like the one described in this case?
  • 2.) Have you ever had a patient suffer this outcome?
  • 3.) Based on this brief summary of the case, do you believe that this patient might have had a better outcome had the care rendered been different?

Expert Witness Response E-021658

I would be happy to review this case of posterior laryngeal cleft. This is not a common condition, but certainly one that I treat and have expertise in. I have never had a patient of mine suffer this outcome. Within the limits of the brief summary of the case, a better outcome may have been possible. This would be especially true if the patient was continued on an oral diet without investigation of the aspiration.

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