Proudly Serving Volusia
& Flager Counties

Since 1985

Delayed Lab Results Lead To Endocarditis And Heart Valve Damage | Ormond Beach Medical Malpractice Attorney

Delayed Lab Results Lead To Endocarditis And Heart Valve Damage

When you get lab work done in a hospital or medical facility, you expect to be notified in a timely manner of any abnormal or life-threatening results.

This didn’t happen for a woman who tested positive for Group B streptococcus, a bacterial bloodstream infection. Attempts by hospital staff to reach the patient were unsuccessful before she returned to the emergency department or ED five days later and was diagnosed with endocarditis, an inflammation of the inside lining of the heart chambers and heart valves.

Endocarditis typically occurs when bacteria or other germs from another part of your body spread through your bloodstream and attach to damaged areas in your heart. Left untreated, endocarditis can damage or destroy your heart valves and can lead to life-threatening complications.

The patient and her husband sued the emergency room physician and the licensed practical nurse (LPN), alleging that a delay in implementing the appropriate treatment for her septicemia resulted in bacterial endocarditis and damage to her aortic valve. This case was settled against the ED physician for more than $1 million.

The 41-year-old female was referred by her new personal care physician or PCP to the local ED with complaints of fever, severe headache for six days, myalgias, and joint pain.

In the ED, she also reported that she had had recent episodes of fainting in the shower and nausea. Her initial evaluation revealed a temperature of 103, blood pressure of 135/77, heart rate of 128, and respiratory rate of 20. A CT scan of her head was normal; a lumbar puncture was negative; and she was not pregnant. The patient had two blood cultures drawn, and was treated with a single dose of IV antibiotics.

Because her providers believed that her symptoms were improving, she was discharged with instructions to follow-up with her PCP within a week.

Two days later, her blood cultures came back positive for Group B streptococcus. The results were received by the ED physician on duty, who had not been her treating physician during her visit. Per hospital policy, a dedicated LPN in the ED followed up on abnormal test results. The LPN tried to reach the patient that afternoon, and left a message to call the hospital.

The following morning, the ED tried again, and was also unsuccessful at reaching the patient. (The phone number the patient gave during triage was for her husband’s workplace).

The staff nurse told the ED physician that she was still unable to reach the patient. No other attempts were made over the weekend, as the doctor felt the patient should be fine with the one dose of IV antibiotics she received during her first ED visit. Additionally, the patient’s chart included no documentation of the identity of the PCP, who had initially called the ED to let them know that she was coming in.

On Monday, the patient returned to the ED with chills and a fever of 103. Her white blood cell count was 12.1, and a chest x-ray was negative, as was an initial echocardiogram at the bedside. Her positive blood culture results were obtained, and the patient was admitted for IV antibiotics.

The patient was diagnosed with bacterial endocarditis. This was confirmed by a transesophageal echocardiogram with vegetation noted on the aortic valve. The patient experienced some complications of supraventricular tachycardia during her stay. She was discharged 15 days later, and remained on IV antibiotics for five weeks.

A month and a half later, the patient was admitted with a left thalamic stroke, which resolved with no residual side effects. The patient is currently healthy, but will most likely require an aortic valve replacement in the future.

The woman and her husband and their attorney had a strong medical malpractice case against the physician for the following reasons:

  • The ED lacked a system to ensure that all abnormal results are relayed to a discharged patient in a timely manner. Abnormal results with serious implications require more determined follow-up to ensure that the patient receives the appropriate care in a timely manner. ED policies should address an appropriate number of attempts to contact a patient and what to do if those attempts are unsuccessful. If the case poses an immediate threat to the patient, the police might be utilized.
  • The physician who received the abnormal lab results is held accountable for transmitting the results in a timely manner. Although the physician who received the abnormal lab results had not seen the patient, she was ultimately held accountable. Even if a subordinate is in the role of contacting a patient with abnormal test results, the court will determine whether the physician provided the appropriate supervision, including a more active role when the situation calls for increased vigilance, as this case did.
  • The LPN was responsible for deciding which values were abnormal and which required additional follow-up. It is important to make sure every individual has the appropriate credentials and supervision to make the decisions necessary to perform the job effectively. Routine evaluation of individual skill sets can be helpful to this end.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.



Learn more about finding and hiring a good lawyer.
Order your FREE BOOK today.

Get more information on Medical Malpractice in our firm’s library.
Medical Malpractice Limits
Proving a Medical Malpractice Case
Avoiding Life Threatening Infections In Hospitals
Pain Treatment Malpractice
Check To See If Your Doctor Is a Criminal

Contact Zimmet & Zimmet for your FREE BOOK.


More Testimonials