There’s a problem in healthcare that I’ve seen more often over the past few years, in my practice as a Houston, Texas medical malpractice attorney at Painter Law Firm. It’s the problem of doctors wanting to treat a CT scan instead of a patient sitting right in front of them. To be fair, I could make the same comment about an MRI scan or even some types of lab work.
Just in the last week, I’ve had this problem come up in two different cases.
In one case, I was taking the deposition of a plastic surgeon in a Harris County medical malpractice case where he is named as a defendant. I confronted the surgeon with photos and medical records showing that his post-operative patient had redness, swelling, pain, and discharge from the area for surgery. The doctor discounted all of this, though, because some blood work that he ordered didn’t show an elevated white blood cell count.
White blood cells are one of the ways that the body fights an infection. While in many cases, a patient with an infection will have an increased white blood cell count on lab work, that’s not always the case. In fact, there are many instances where a patient has a serious or deep infection and the white blood cell count isn’t elevated at all.
This plastic surgeon persisted in ignoring textbook signs and symptoms of a wound infection simply because this one lab value wasn’t abnormal. When the patient pressured him into finally taking a sample of the fluid discharge and sending it to a laboratory for a culture and sensitivity study, the results came back showing that she had not one, but three bacterial infections.
In my second example, we’ll get back to CT scans. A woman went to a hospital emergency room (ER) because of severe abdominal pain. About a year earlier, she had a Roux-en-Y gastric bypass surgery. A few months before going to the ER, she had bouts of abdominal pain and had surgery to address mesenteric volvulus.
The mesentery is a fold of membrane that secures the intestines to the abdominal wall. Volvulus is a condition where the mesentery (or stomach or intestine) twists, kind of like a phone cord, causing an obstruction and, if untreated, lack of blood flow that can kill the organ or tissue.
When this patient went to the ER, she told the doctor that her abdominal pain felt similar to her volvulus six months earlier, which required surgery. The doctor appropriately ordered an abdominal CT scan. According to our radiology expert, the hospital’s radiologist made a mistake in reading the CT scan, finding no evidence of volvulus. Instead, the radiologist felt that the CT scan showed that the patient was constipated.
She was admitted to the hospital under the care of two hospitalists. Hospitalists are hospital-based internal medicine physicians who act as the quarterbacks for patient care by looking at the big picture and bringing in any specialty medical consultants that are needed.
According to our experts, the hospitalists bought in to the radiologist’s incorrect CT findings. Without apparently considering any other explanation for her severe abdominal pain, nausea, vomiting, constipation, and inability to pass gas, over the course of days the hospitalists gave her more and more laxatives. That only made things worse.
These hospitalists ignored the patient in front of them and didn’t make a differential diagnosis list and work through it, while the patient suffered. Eventually, she deteriorated to such a point that a second CT scan was done. This time, a different radiologist interpreted it as showing a bowel obstruction, which is consistent with the volvulus.
By the time she was taken to surgery, a significant amount of her bowel had died because of a lack of blood flow over the course of the days that her physicians were treating her CT scan, but not her. The surgeon removed dead bowel, leaving her with severe lifelong digestive and intestinal problems.
What you can do
Diagnostic radiology scans (CT, MRI, or ultrasound, for instance) and laboratory work are great tools that are available to doctors. Sometimes, though, doctors act like they are the only tools in their belts, and that creates a tremendous danger for their patients.
If your doctor is ordering radiology or lab work, have a polite conversation about why the tests are being ordered in the first place. Ask what the doctor expects to find, what would be good news, and what would be bad news. And then follow up to make sure that you get a copy of the results, along with an explanation of what they mean.
Remember that negative or inconclusive studies don’t necessarily mean that there’s not a serious problem that requires further medical attention and workup. If you continue to have bad symptoms or problems, speak up and be your own advocate. Make sure you get the attention of your doctor and, if necessary, ask for a specialist consultation or second opinion.
If you’ve been seriously injured because your doctor insisted on treating radiology scans or lab work, instead of your symptoms, then contact a top-rated, experienced Houston, Texas medical malpractice lawyer for help in evaluating your potential case.