Failure to Diagnose Pneumonia in a Diabetic
The Brynmawr Case
A 55 year old husband, active in the workplace, had a history of controlled insulin dependent diabetes (IDDM) or Type I diabetes. He became sick, short of breath, tired and had difficulty sleeping. Both his sugar level and blood pressure were noted to be high that evening and the next morning. The client was seen by his primary care physician where a physician’s assistant (PA) noted complaints of a several week history of sluggishness and shortness of breath. The PA noted decreased breath sounds in both lower lungs. A urine dipstick showed a glucose level greater than 2000 (less than 120 would be normal) with large amounts of protein and blood in the urine (all signs of raging infection.) The PA’s assessment was non-controlled IDDM, hematuria (blood in the urine), proteinurea (protein in the urine) and possible pneumonia. Pneumonia is a very ominous finding in a diabetic. The PA ordered fasting blood work and a chest x-ray. She negligently failed to immediately institute anti-biotic therapy and failed to arrange an immediate chest x-ray in a facility that would allow the x-ray to be read and acted upon immediately. The chest x-ray, taken that afternoon, revealed left lower lung pneumonia with a large amount of fluid. No physician was available to read the x-ray or order antibiotics. Antibiotic therapy was not instituted for three days. On the fourth day after the visit, the treating primary care physician saw the patient and diagnosed non-controlled IDDM (diabetes), hematuria and pneumonia, but carelessly and negligently failed to recognize the patients’s severe pneumonia and septic condition (body-wide severe infection.) The patient died of pneumonia in his sleep that night.
An immediate hospital admission for IV antibiotics and intensive control of his diabetes would have prevented the death.
The client was a resident of Fayette County Pennsylvania and received his medical care in Fayette County. Suit was filed in Allegheny County because of peculiarities in the ownership of the physician’s practice group. A jury rendered a six figure verdict after two days of deliberations.