One frequent emergency room complaint is abdominal pain of unknown origin. The challenge for the ER doctor is to diagnose the source of the problem, or at least narrow the problem, and rule out life threatening aliments. Three big potentials for problems are appendicitis, volvulus, and ruptured abdominal aortic aneurysm and intussusception – all can lead to misdiagnosis and wrongful death malpractice lawsuits. Today, we will look at appendicitis misdiagnosis claims.
Failure to diagnose an appendicitis is a common failure. It is critical to immediately remove an inflamed appendix before it ruptures. If a patient walks in with an inflamed appendix and walks out before getting the proper treatment – usually removal – they are put at risk of death. Particularly at risk for an appendicitis and a missed diagnosis is our youngest and oldest. The classical appendicitis presentation includes patients with low grade fevers with crampy, intermittent abdominal pain that gets worse with movement that migrates to the right lower quadrant of the stomach within 12–24 hours of the onset of symptoms.
Some emergency room doctors miss even the obvious diagnosis in patients most at risk. There are medical malpractice cases where the patient could just have well come in the emergency room with an “I have an inflamed appendix” shirt and the ER doctor still blows it. But the standard of care also requires ER doctors to catch more than just the fly balls. For moderate risk patients that have some, but not all of the classic appendicitis symptoms, doctors really do need to order more follow-up diagnostic testing. Call it defensive medicine, call it whatever you want, but if it looks like it could be an appendix problem, it’s worth getting a CT scan.
But a negative CT scan is not game, set, match on the question of appendicitis. If patients continue to present with other symptoms and there is no clear differential diagnosis made, doctors need to consider admitting the patient and conducting more tests. Certainly, a hospital is a safer place to have an appendicitis than your living room. If the patient is discharged – which is appropriate in some cases – the discharge instructions need to be crystal clear – negative CT scan or not – that continued or further symptoms warrant follow up.
If you think you may have an injury or wrongful death medical malpractice claim as a the result of a problem with an undiagnosed appendix problem, call 800-553-8082, or get a free online consultation.