Accepting the Presenting Complaint as the Whole Story Could Doom Your Patient and Land You in Court

The operator of a Missouri urgent care center was at the center of a tragic story in which a 1-year-old patient died—with that operator found culpable in the ensuing lawsuit and ordered to pay a $1.8 million judgment. (The jury had originally ordered the company to pay $3 million, which exceeds the state cap on malpractice suits.) The boy’s parents first brought him to a primary care clinic with symptoms attributed to pneumonia. Months later, they took him to an urgent care center within the same health system because he was pale and lethargic. This time, he was diagnosed with and treated for an ear infection. He died just hours later, with his death ultimately attributed to Kawasaki’s disease. The parents contended that if clinicians at either of the two clinics had done a more thorough examination their son could have been diagnosed correctly and received proper treatment. That premise is hypothetical, but the fact remains that not doing so left the operators open to blame in this worst-case scenario. While “defensive medicine” has been derided far and wide with good reason, it would behoove clinicians and benefit patients to keep an open mind as to possible causes for symptoms that could seem relatively mundane. JUCM published an article on a similar case. It could hold valuable lessons. You can read A 5-Month-Old with Symptoms Beyond the Presenting Complaint in our archive.