This wrongful death claim was filed in Montgomery County after a child died due to an untreated elevation in his blood glucose levels. It was filed in Health Claims Arbitration on March 26, 2018, and it is the 142nd medical malpractice case filed in Maryland this year.Summary of Plaintiff's Allegations
A boy went for routine pediatric check-ups with his family medicine doctor since he was nine years old. During an appointment at age eleven, the boy's blood glucose was found to be slightly elevated. Neither the boy nor his father was notified of the elevated glucose.
Three years later, when the boy was fourteen years old, his pediatrician took a blood and urine sample. The pediatrician received results of the sample analyses from LabCorp, which showed multiple abnormalities including a significantly elevated glucose level. Again, the pediatrician failed to inform the boy or his father about the abnormal blood test results.
When the boy began to experience nausea and vomiting approximately three months later, he and his father thought it was a virus. Unbeknownst to them, these symptoms were actually caused by diabetic ketoacidosis - a life-threatening complication of untreated diabetes. In diabetic ketoacidosis, almost all the body's cells lack energy no matter what the blood glucose levels are. It is characterized by hyperglycemia, acidosis and elevated plasma ketone concentration.
After two days of nausea and vomiting, the boy was found dead in his home. The autopsy report lists his cause of death as diabetic ketoacidosis.Additional Comments
- Diabetic ketoacidosis occurs when the body can't produce enough insulin to handle high levels of glucose in the bloodstream. Normally, insulin helps glucose enter cells to be used as a source of energy. When the body doesn't have enough insulin, the body can't use glucose as fuel so it starts to break down fat instead. This process causes a buildup of acids (ketones) in the bloodstream. Ketoacidosis causes what is essentially starvation.
- Glucose is the primary form of sugar we use to burn energy. Most other forms of Almost sugar are converted to glucose. This is broken down to give us energy. We all need insulin. It is required for the entry of glucose into almost all human cells. When no insulin is produced, you can't get fuel (glucose) to the cells. The result is no energy. So the body goes to fat.
- According to the accepted standards of medical care, pediatricians must report all lab results to the parent(s) of an underage patient. Not only did the defendant pediatrician fail to uphold medical standards by failing to tell the boy's father about the abnormal blood test results, she also failed to treat the elevated glucose levels appropriately. After his first abnormal blood test results, the boy should have been tested for diabetes and sent to an endocrinologist for follow-up care.
- Most patients who develop diabetic ketoacidosis are insulin-requiring diabetics (usually Type 1). The major complications of Type I diabetic ketoacidosis are hypoglycemia, hyperkalemia, electrolyte abnormalities, hypotension, cardiac abnormalities and cerebral edema.
- Montgomery County
- Family medicine doctor
- Alternative Primary Care, P.C.
- Failing to recognize and timely act upon the boy's diabetes.
- Failing to appreciate the significance of the elevated glucose level in relation to the boy's age and risk factors.
- Failing to intervene in a timely manner so as to prevent the boy's diabetes exacerbation and resulting death.
- Failing to timely refer to a specialist, arrange for diabetic care, consultations, and follow-up.
- Failing to administer appropriate diagnostic testing, medication, and treatment.
- Failing to communicate in order to formulate an appropriate treatment plan.
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