Kawasaki Disease Delayed Diagnosis Lawsuit

Robinson v. Johns Hopkins Community Physicians

Kawasaki DiseaseThis medical malpractice claim was filed in Baltimore City after a delayed diagnosis caused an infant to suffer advanced complications of Kawasaki disease, including heart damage. It was filed in Health Claims Arbitration on February 15, 2018, and it is the 80th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

Parents brought their eight-month-old son to the Johns Hopkins health center with flu-like symptoms. During the initial exam and subsequent visits over the next ten days, the boy's symptoms and outward appearance suggested that he was suffering from Kawasaki disease. Despite the fact that Kawasaki disease is the leading cause of acquired heart disease in children, the family doctor failed to timely refer the baby for further evaluation.

Three weeks later, the baby was finally referred to a pulmonologist and properly diagnosed with Kawasaki disease. He was promptly provided with treatment, but it was too late to reverse the damage done to his heart, including the development of an aneurysm.

Additional Comments

The complaint does not tell us much. There are certainly a lot of defense verdicts in these cases, usually because the children presented with atypical Kawasaki disease. Here are some additional facts that are important whether trying to figure out whether you have a Kawasaki disease misdiagnosis claim:

  • Kawasaki disease primarily affects children and infants. Eighty-percent of those diagnosed with Kawasaki are younger than five years.

  • Any medium-sized arteries in the body can be affected, but Kawasaki disease tends to target the coronary arteries, which supply the heart with blood. It's rare for Kawasaki disease to cause serious complications such as myocarditis or heart valve problems because its unique symptoms make the disease easy to diagnose.

  • The diagnosis of Kawasaki Disease is based on the clinical examination of a child, the documentation of fever for 5 or more days, plus the finding of 4 of the following 5 characteristic features: 1. bulbar conjunctivitis without exudates; 2. red mouth and pharynx, strawberry tongue, and red, cracked lips; 3. a polymorphous rash; 4. changes in the hands and feet consisting of induration and red palms and soles; and 5. a solitary, usually unilateral enlarged cervical lymph node.

  • Other features including irritability, abdominal pain, diarrhea, vomiting, sterile pyuria, liver dysfunction, arthritis or arthralgia, aseptic meningitis, gallbladder hyrops may be present. Additionally blood tests can collaborate these findings.

  • But Kawasaki's Disease has long been recognized as a possible cause of prolonged fever in infants and children. A child can have a fever for 5 or more days but not four distinct findings and still have Kawasaki Disease:

  • Children with Kawasaki's disease can have an incomplete course but they still need immunoglobulin and aspirin treatment.

  • Treatment for Kawasaki disease typically requires hospitalization while the patient receives a variety of medications. The cause of Kawasaki disease is unknown, so treatments usually aim to soothe painful symptoms and prevent heart damage while the illness runs its course.

  • Doctors can do blood testing and an echocardiogram in an effort to rule in or out Kawasaki's disease.

Jurisdiction
  • Baltimore City
Defendants
  • James Henry Jenkinson (executor of the estate of Wanda Raczkowski, M.D., deceased family physician)

  • The Johns Hopkins Health System Corporation

  • Johns Hopkins Community Physicians, Inc. d/b/a Johns Hopkins Community Physicians at Hager Park

Hospitals Where Patient was Treated
  • Johns Hopkins
Negligence
  • Failing to timely diagnose and treat Kawasaki disease.
  • Failing to perform the appropriate diagnostic testing.
  • Failing to refer the claimant to a specialist.
Specific Counts Pled
  • As a direct result of the defendants' negligence, the claimant sustained permanent injuries to his heart and cardiovascular system requiring medical care and treatment, limiting his activities, and shortening his life expectancy.

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