Case details

Failure to diagnose tuberculosis resulted in paralysis: student

SUMMARY

$5000000

Amount

Settlement

Result type

Not present

Ruling
KEYWORDS
paralysis, quadriplegia
FACTS
On Aug. 6, 2009, the plaintiff, a 14-year-old student, presented to a medical health center after a tuberculosis skin test turned out to be positive during her physical entry exams that she had in preparation for her freshman year of high school. Since the test indicated that she had been exposed to tuberculosis, the health center prescribed antibiotics and referred her to an imaging center for a chest X-ray, which was ultimately performed by a radiologist and read as negative. As a result, the student was released from medical care and began her freshman year of high school. However, in September 2009, she began experiencing neck pain and weight loss, causing her to return to the health center on Sept. 22, 2009. The medical staff subsequently opined that the student’s neck pain could be caused by her school backpack and referred her back to the imaging center for a cervical X-ray, which was performed by the same radiologist and read as cervical changes at the C4 level. The radiologist, in his report, determined that the changes were mostly likely congenital in nature, but couldn’t rule out destructive changes. He then sent his report to the health center. Following her cervical X-ray, the student returned to school with no further treatment at the health center. However, in August 2010, during the beginning of her sophomore year, the student was on line at school to pick up her schedule when she collapsed to the ground when a vertebra in her cervical spine ruptured. The student was ultimately diagnosed with Pott’s Disease, a tuberculosis bacterium lodged in the spinal cord, and was rendered a partial quadriplegic. The student’s father, acting as his 14-year-old daughter’s guardian ad litem, sued the health center, the imaging center, the radiologist, the supervising physician at the health center, and a nurse practitioner at the health center, as well as two other physicians, an internist and a family medicine physician. The father alleged that the defendants failed to diagnose his daughter’s condition and that this failure constituted medical malpractice and general negligence. The internist and family medicine physician were both ultimately dismissed from the action for not having any involvement with the student’s treatment. Plaintiff’s counsel contended that when the student presented to the health center in September 2009 and was referred for a cervical X-ray, which was read as showing cervical changes, it should have led to a more serious diagnostic, such as an MRI or CT scan, being performed. Counsel also contended that due to the student’s positive test for TB in the summer of 2009, the changes indicated in the X-ray should have been a major cause for concern, resulting in immediate action. Thus, plaintiff’s counsel asserted that the health center defendants were negligent in their care of the student during her initial visit in August 2009, contending that the student was not treated with antibiotics for the appropriate amount of time nor was she referred for a proper diagnostic study. Counsel further asserted that the radiologist, working out of the imaging center, improperly read the cervical X-ray as congenital, and should have called the County Health Department and the health center with his findings. The radiologist claimed that while he determined that the cervical changes in the X-ray were most likely congenital in nature, he could not rule out destructive changes. He claimed that as a result, he recommended further evaluations, consisting of an MRI and a possible CT scan, when he sent his report to the health center. The health center defendants disputed plaintiff’s counsel’s contention that the student wasn’t administered the proper amount of antibiotics. They also claimed that after the student’s chest X-ray, the County Health Department was consulted and an initial three-month course of antibiotics was prescribed. In addition, they claimed that the student was to follow up at the health center after one month, which she died, as well as 82 days after the prescription was given. However, the health center defendants claimed that at the three-month follow-up appointment, the student’s mother advised them that her daughter had stopped the medication, as she thought her daughter was cured. The health center defendants claimed that as a result, they advised both the student and her mother of the importance of continuing the antibiotics and provided them with a refill prescription for an additional three months. Counsel for the health center defendants subpoenaed pharmacy records and contended that the records showed that the refill was never filled. In response, the student’s mother denied ever making a comment about believing her daughter was “cured,” and denied being given a second prescription for the antibiotics., A vertebra in the 14-year-old student’s cervical spine ruptured, causing her to collapse to the ground. She was subsequently taken to an emergency room, where an MRI revealed an abnormality in her cervical spine. She was then airlifted to a children’s hospital in Palo Alto, where she was diagnosed with Pott’s disease and began treatment to rid her body of tuberculosis. However, as a result of the ruptured vertebra, the student was rendered a partial quadriplegic, with some movement in her upper extremities. The student acknowledged that she does have some movement in her upper extremities and has ability to use items, such as her iPad, with a stencil, but claimed that she is completely dependent on others and requires assistance with all aspects of her everyday life. Plaintiff’s counsel contended that the student requires professional, 24-7 attendant care for the remainder of her lifetime. Thus, the student sought recovery of $350,000 in past medical costs, in excess of $15 million for her future life care plan and loss of earning capacity, as well as an unspecified amount of damages for her past and future pain and suffering.
COURT
Superior Court of Stanislaus County, Modesto, CA

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