The plaintiff presented to the Emergency Department shortly after 10:00 a.m. on November 24, 2019, complaining of redness on her left buttock, significant pain on her buttock and lower back, chills, fevers at home to 102 ℉, and fatigue. She had a significant medical history, including obesity, insulin-dependent Type 2 diabetes mellitus, hypertension, hyperlipidemia, and rheumatoid arthritis. She was a half-a-pack-per-day smoker.
Due to concern for an abscess and/or infection in the left gluteal region, an emergent CT scan of the abdomen and pelvis was performed. The CT revealed soft tissue edema and fat stranding in the left gluteal region without abscess or other fluid collection. A CBC revealed a significantly elevated WBC of 23.8.
The plaintiff was then admitted to the Med/Surg Floor to rule out sepsis. She was administered IV antibiotics (Vancomycin) for 23 hours, and her vital signs were monitored.
The plaintiff remained in the observation area of the emergency department overnight. She was given Ibuprofen, Tramadol, and ice packs for pain control. A second CBC at 2:00 a.m. on 11/25/19 revealed a still very elevated WBC of 22.9.
On the morning of 11/25/19, the plaintiff was examined by the hospitalist, who documented a “receding cellulitis” and improvement in the plaintiff’s pain in the left buttock. The hospitalist discharged the plaintiff home with a prescription for oral antibiotics, pain medication, and instructions to return to her primary care doctor if symptoms worsened.
The plaintiff re-presented on November 27, 2019, via ambulance after being seen by her primary care physician, who noted a 6-centimeter area of erythema and tender, hard tissue extending to the perineum on the left buttock. Upon arrival at the hospital, she complained of upper thigh pain and was unable to sit or stand. Fevers and lethargy were reported, with pain and erythema to the left buttock, left thigh, labia, and lower back. A CT scan confirmed the diagnosis of Fournier’s Gangrene and Necrotizing Fasciitis.
Emergent surgery, with incision and drainage of the left buttock, was performed. The plaintiff developed septic shock, which ultimately led to a significant spinal cord infarct. She underwent twelve additional surgeries while in the hospital, which included incisions and drainages. She deteriorated neurologically throughout her hospital admission to the point of being unable to move three of her extremities.
She was discharged on January 14, 2020, to a rehabilitation facility, where she remained until May 28, 2020. She had little, if any, improvement during her rehab stay. Since her discharge, she has remained mostly bedbound, dependent on her family for assistance with all activities of daily living. She also has bowel and bladder incontinence. All of her injuries are permanent.
The plaintiff claimed that the defendant was negligent in prematurely discharging her from the hospital on November 25, 2019, and was negligent in failing to call an infectious disease consultation prior to discharge. It was further claimed that due to the defendant’s negligence, the plaintiff lost a substantial chance of cure of her infection. The plaintiff contended that despite the plaintiff’s normal vital signs on discharge, she continued to have a significantly elevated white blood cell count and severe pain.
The defendant claimed that it was within the standard of care to discharge the plaintiff on November 25, 2019, due to receding cellulitis, normal vital signs, downtrend of WBC, and reduced pain, and that giving her oral antibiotics and instructions to follow up with her primary care doctor was an appropriate discharge plan. The defendant further claimed that even if the plaintiff had been kept in the hospital, it would not have changed her development of Fournier’s Gangrene and Necrotizing Fasciitis, which are notoriously difficult to diagnose and treat.
Duffy and Duffy was able to help the plaintiff secure a $6,250,000.00 settlement just prior to jury selection. Call now to learn more about this case and how our attorneys could help with your medical malpractice case.
