The plaintiff alleged that she presented to the emergency department with signs and symptoms consistent with acute appendicitis. However, the ER physician found suprapubic tenderness with a history of some dysuria. The ER physician ordered a CT of the abdomen and pelvis which was read by the defendant radiologist as showing no acute process in the patient’s abdomen and pelvis. The ER physician developed a preliminary diagnosis of a urinary tract infection and had the patient admitted to the hospitalist service. After receiving one dose of Rocephin and IV hydration, the patient’s condition quickly improved to the point she was pain and symptom free by the following morning. As a result, she was discharged home with a three day course of Keflex.
The plaintiff alleged that her appendicitis smoldered for the following four months with some bouts of abdominal discomfort treated with a change in diet and no care and treatment from a physician. The plaintiff again presented to the emergency department at the same hospital where, following two days of evaluation and radiological imaging, she underwent an exploratory laparotomy where enteric contents were found in the abdomen. An ileocecectomy was performed as a result. Pathology showed a perforation of the small bowel with no perforation of the appendix.
The plaintiff presented expert testimony to argue that the alleged appendicitis was “cooled down” by the initial antibiotics which allowed it to persist until eventually rupturing 4 months later. The defendant’s experts included specialists in radiology, infectious disease and general surgery. They countered with testimony that the original CT showed no evidence of any inflammatory process of any kind, that no surgical intervention was indicated at that point, that an acute appendicitis could not persist for 4 months due to the limited antibiotics course, that appendicitis could not be treated with a change in diet and that, based on pathology, the patient’s appendix never ruptured.
After a few hours of deliberation, the jury returned a verdict in favor of the defendant radiologist.