Lawsuit alleges freestanding ER and trainee doctor cause girl’s death of bacterial meningitis
Resident physician diagnoses patient with ear infection, but five hours after discharge it was too late to save her
In my law practice as a Houston, Texas medical malpractice attorney, I have represented many clients in cases involving bad emergency room care.
Texas is home to more freestanding emergency rooms than any other state in America. You probably have seen them before—they are popping up in strip malls and neighborhoods all over Houston. They are called “freestanding” because they are not connected to a hospital.
Regardless of whether a patient goes to a hospital emergency room or a freestanding ER, there is an expectation of being treated by a trained emergency physician. Unfortunately, that is not always the case when it comes to freestanding facilities.
Testicular torsion misdiagnosis
I recently settled a lawsuit on behalf of a young man who lost a testicle after seeking prompt treatment at a freestanding ER in Kingwood, Texas.
The patient suddenly woke up in the middle of the night with terrible testicular pain, nausea, vomiting, and a swollen testicle. These are all classic symptoms of the dangerous condition, which means that the testicle’s spermatic cord had gotten so twisted that it cut off blood flow. Testicular torsion is an emergency condition that requires prompt diagnosis and surgical treatment to decompress the twisted spermatic cord, of the testicle will die.
When the young man’s mother took him to the freestanding ER, he was seen by a board certified internal medicine physician, who diagnosed him with mesenteric adenitis—a tummy ache. Our emergency medicine expert witness testified that the standard of care required an emergency physician to begin immediate treatment based on the clinical suspicion of testicular torsion, order a color Doppler testicular ultrasound, get an emergency urologist consultation, and get the patient to a facility that can perform emergency surgeon.
Unfortunately, the internal medicine doctor who saw this young man did “none of the above” and just gave him pain medications. When the pain did not go away, the patient went to Texas Children’s Hospital, where he was promptly diagnosed. By then, though, it was too late, and he had to have his testicle surgically removed.
Bacterial meningitis death
A recent Dallas medical malpractice lawsuit against Excel ER, in Keller, Texas, involved a story with a sad ending.
A dad found his daughter in bed one afternoon, cold and blue, with vomit on her face. The parents and their daughter had only been home for five hours from an emergency room visit the night before.
In the middle of the night, the mom and dad had taken their daughter to a neighborhood Excel ER because of her 101 degree temperature, rapid heartbeat, and abnormal breathing. The doctor at the freestanding emergency room diagnosed her with an ear infection. She was given fluids and discharged home with a prescription for antibiotics.
According to medical experts, during the first ER encounter, there were clear red flags that pointed to bacterial meningitis, including fever, vomiting, and diarrhea within the previous 24 hours, on top of the elevated heart rate and abnormal breathing. In addition, the little girl had other conditions that put her at a heightened risk for developing bacterial meningitis; she was deaf and had a cochlear implant. On top of all of that, her blood work came back grossly abnormal, with white blood cell and platelet counts that should have signaled a bacterial infection to a competent physician.
By the time they got her to an emergency room the second time—this time in a hospital—it was too late. An autopsy revealed that her primary cause of death was bacterial meningitis.
Bacterial meningitis is an extremely deadly infection of the meninges, a layer surrounding the brain and spinal cord. Without fast and correct treatment, it can overtake a patient quickly and cause death.
According to the lawsuit, the doctor who saw the little girl was a medical resident, not a fully-trained physician. This provider had graduated from medical school and was a medical doctor, but had not completed his post-graduate residency training in emergency medicine.
It is not unusual to have medical residents taking care of patients in major academic hospitals, like Texas Medical Hospitals including Memorial Hermann, Texas Children’s, St. Luke’s, and Houston Methodist hospitals. In academic facilities, the resident doctors are supervised by fully-trained attending physicians.
In suburban hospitals, like Houston Methodist Willowbrook, St. Luke’s The Woodlands, or Memorial Hermann Katy hospitals, treatment is typically by fully-trained doctors, rather than residents.
I was surprised to learn that a freestanding ER, not connected to a hospital, was not staffed with a board certified physician in any specialty at all, let alone emergency medicine.
Yet, residents frequently moonlight, oftentimes without any supervision. In this little girl’s case, her family and medical experts believe that a fully-trained emergency room doctor, instead of a moonlighting trainee, would have saved her precious life.
We are here to help
If you or a loved one has been seriously injured or worse, as a result of medical negligence, call the experienced lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is a former hospital administrator and a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He files medical negligence and wrongful death lawsuits against hospitals, freestanding emergency rooms, doctors, surgeons, anesthesiologists, and other healthcare providers. He has focused his entire legal career on health care malpractice cases.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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Published in the July/August 2018 edition of "The Houston Lawyer" magazine