This medical malpractice claim was filed in Baltimore City after a physician neglected to refer a patient for the appropriate screening to diagnose his brain tumor and primary immunodeficiency disease. It was filed in Health Claims Arbitration on February 7, 2018, and it is the 66th medical malpractice case filed in Maryland this year.Summary of Plaintiff's Allegations
A man went to see an internal medicine physician at Johns Hopkins Hospital with complaints of increased thirst, urinary frequency, dizziness, confusion, fatigue, and headaches. The doctor reviewed an MRI study and a diagnostic lumbar puncture procedure that the man had previously undergone, which showed brain and cerebrospinal fluid abnormalities. The doctor initially thought that the abnormalities indicated "diabetes insipidus," a disorder that occurs when the body can't regulate salt and water, causing thirst and frequent urination. The man was never recommended for a brain lesion biopsy or a neurosurgical consultation.
For the next eight months, the man's medical condition was managed by the internal medicine doctor, who ordered three brain MRIs and two lumbar punctures during that time. Both studies, along with the man's worsening symptoms, continually demonstrated a decline in the man's condition.
Still, a brain lesion biopsy was never discussed. After the last MRI, the internal medicine doctor referred the man to a neurosurgeon, but the neurosurgeon also failed to order a brain lesion biopsy. Instead, he recommended yet another brain MRI in six weeks.
Due to his progressively worsening condition, which included severe dizziness and double vision, fatigue, memory problems, and difficulties with complex tasks, the man and his wife relocated to California to be closer to family. Finally, after a neurosurgical consultation in California, the man was referred for a diagnostic brain lesion biopsy, which identified a brain tumor and a type of chronic immune cell inflammation that increases the body's susceptibility to infection.
As a direct result of the brain lesion biopsy, the man was diagnosed with a multifocal germinoma brain tumor, a germ cell tumor involving the ventricles and extending into the cervical spine. He started radiation therapy with positive results, and follow-up diagnostic imaging identified a stable disease with no residual brain lesions.Additional Comments
The medical term for the man's immune disorder is "chronic lymphocytic and granulomatous inflammation," which primarily affects the central nervous system and cells called "neutrophils" in the immune system. Lymphocytic inflammation, often referred to as CLIPPERS, is a poorly understood and difficult-to-diagnose condition that infiltrates the brain with inflammatory cells. The man in this claim had a typical clinical presentation, with altered facial sensation, double vision, spasticity, and an inability to fully control bodily movements. He was simultaneously suffering from Chronic Granulomatous Disease (CGD), meaning that it is difficult for his neutrophil cells to produce hydrogen peroxide. Since the immune system needs hydrogen peroxide to fight certain types of illnesses, patients with CGD can get very sick from infections that wouldn't have such a dramatic effect on the average person.
You cannot help but expect a bad ending to this story as you read it. But ultimately the patient has a great outcome. Germinoma brain tumors have a high cure rate. This lawsuit is about the pain and suffering that came from the delayed diagnosis.
The defense to this case is going to revolve around how rare this condition is, particularly in adults.
- Baltimore City
- The Johns Hopkins Hospital
- A doctor specializing in internal medicine, neurology, and neuropathology
- A doctor specializing in neurology and neurological surgery
- Johns Hopkins Hospital
- Saint John's Health Center
Failing to obtain timely consultations with specialists.
Failing to conduct appropriate assessments, examinations, evaluations, and diagnostic testing.
Failing to timely and appropriately react to signs, symptoms, and findings illustrative of the claimant's serious medical condition.
Failing to recognize the significance of the claimant's lab results and other diagnostic findings.
Failing to provide informed consent.
As a result of the defendants' negligence, the claimant has suffered the following injuries, damages, and losses: pain, mental and emotions distress, neurological and bodily injuries, disability, disfigurement, stress, diminished quality of life, loss of the ability to conceive children, loss of the ability to perform activities of daily living, unnecessary hospitalizations and procedures, and loss of earning capacity.
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