Failure to Diagnose Influenza Lawsuit in Baltimore

Hale v. Defendant Doctor

misdiagnosisThis is a failure to diagnose influenza lawsuit filed on behalf of a man in Baltimore County. It was filed in Health Claims Arbitration on April 17, 2017. It is the 183rd medical malpractice suit filed in 2017 in Maryland.

Summary of Plaintiff's Allegations

A 62-year-old diabetic man develops flu like symptoms and a fever. The typical symptoms of influenza are fever, cough, headache and muscle aches.

He goes to defendant doctor and is diagnosed with a viral syndrome and instructed to take Ibuprofen. The man is not tested for influenza nor is he given Tamiflu. This prescription medication is the trademark for oseltamivir phosphate, which is an inhibitor of viral neuraminidase used to treat the flu. The critical fact from plaintiff's perspective is that the potential benefit Tamiflu in the treatment of influenza is greatest when started in the first 48 hours of onset of symptoms. Sometimes, the drug is prescribed even if more than 48 hours have elapsed since symptom onset.

That afternoon, his temperature is increasing so he texts his doctor. He texts this same doctor multiple times about his temperature increase. The next morning, he texts defendant doctor again to tell him his temperature is still increasing. Six hours later, the doctor asks him if there are any symptoms besides fever, via text. That evening, the doctor texts the man indicating that he will call an antibiotic into a pharmacy.

The next day, the man has a lack of appetite and stomach irritation. He reports these symptoms to defendant. His condition continues to worsen, and five days after his initial presentation to defendant's office, he is admitted to Greater Baltimore Medical Center (GBMC).

Three days after he arrives at GBMC, the man is intubated and placed on ventilation for acute respiratory distress due to influenza. He develops acute kidney injury and labs reveal influenza A virus. He is transferred to University of Maryland Medical Center. While at there, he undergoes a tracheostomy and he is later transferred to a rehabilitation hospital almost a month later. However, shortly after, he is found pulseless and suffering from severe anoxic encephalopathy due to cardiac arrest. He is taken to Sinai Hospital.

After six days at Sinai, the man is transferred to a hospice facility where he dies two months later. The cause of his death was due to pneumonia and hypoxic respiratory failure. His family files this claim, alleging that the man's death was due to the failure of defendant doctor to diagnose influenza and prescribed Tamiflu within 48 hours of the onset of his symptoms.

Additional Comments
  • It will be interesting to see what plaintiff's expert will say about what the standard of care requires for patients presenting with flu like symptoms. Does the standard of care require doctors to prescribe oseltamivir in every case where the patient presents with flu like symptoms that began in the last 48 hours? If not, what about this patient necessitated Tamiflu.
  • Another unanswered question is how long it too GBMC to make the diagnosis
  • Influenza viruses cause respiratory illness in humans. Typical symptoms are cough, fever, runny nose, sore throat, muscle aches and headache. While influenza is a bad cold for most people, serious complications can occur and cause death. According to the CDC, Between 12,000 and 56,000 American die from the flu every year.
  • Influenza is spread predominantly through large droplet in the air, created by coughing, sneezing and breathing of persons with influenza. Influenza is also spread directly through contact with hands, doorknobs, surfaces, linen, and other fomites.
Jurisdiction
  • Baltimore County
Defendants
  • A family practitioner
Hospitals Where Patient was Treated
  • Greater Baltimore Medical Center
  • University of Maryland Medical Center
  • Sinai Hospital
Negligence
  • Failure to employ appropriate treatment, surgery, tests and/or procedures
  • Failure to carefully and thoroughly evaluate patient's condition
  • Failure to properly evaluate effects of chosen treatment and adjust treatment
  • Failure to properly monitor the course of patient's condition and treatment
  • Failure to diagnose influenza and prescribe Tamiflu within 48 hours
Specific Counts Pled
  • Negligence
  • Agency
Plaintiff's Experts and Areas of Specialty
  • Gary A. Salzman, M.D. - board certified in internal Medicine and subspecialties of Pulmonary Disease and Critical Care Medicine; Missouri. He is a Professor of Medicine at the University of Missouri-Kansas City School of Medicine. He has been named as an expert in at least four cases pending in Maryland.
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