A Tulsa County, Oklahoma medical malpractice jury recently returned its verdict in the amount of $15 million for a child who suffered permanent brain damage and will endure life-long disabilities because a bacterial infection was misdiagnosed in a hospital’s ER and was left untreated. The child’s injuries include spastic hemiplegia and she will require physical therapy, occupational therapy, speech therapy, and specialized care for cognitive and motor impairments for the rest of her life.
The Oklahoma medical malpractice plaintiff alleged that the child was five months old when she was brought to the ER in 2018 with a history of fever, vomiting, decreased urine output, and decreased activity over the course of four days. The on-call pediatric emergency department physician ordered a complete blood count that reportedly showed a significantly elevated white blood cell count and elevated neutrophils, which findings are consistent with a serious bacterial infection. Nonetheless, the child was diagnosed with a viral illness and discharged without a blood culture or antibiotic treatment being ordered. Two days later, the child was brought back to the ER in critical condition. A lumbar puncture at that time confirmed streptococcus pneumonia infection but by then the infection had progressed, causing multiple strokes and permanent brain damage.
The plaintiffs’ experts reportedly testified during trial that the care provided in the ER during the initial visit failed to comply with the standard of care: if a blood culture had been performed at that time, the child’s bacterial infection would have been diagnosed then and with timely and proper treatment, the child would have avoided the catastrophic injuries she subsequently suffered.
Neutrophilia
Neutrophilia is defined as a higher neutrophil count in the blood than the normal reference range of absolute neutrophil count. Neutrophilia can be seen in infections, inflammation, and/or neoplastic processes. Neutrophils are the first line of cells recruited at the site of infection and attack, ingest, and digest microorganisms by producing reactive oxygen species. The most common cause of secondary neutrophilia is infection and inflammation.
Differential diagnosis of neutrophilia includes infections including bacterial, viral, fungal, and parasitic.
Treatment of neutrophilia is based on treating the underlying cause of neutrophilia. Antibiotic and anti-inflammatory therapies should be undertaken for neutrophilia associated with infection/inflammation.
Due to the complexity of this condition, management of neutrophilia-associated conditions requires an interprofessional team of health care professionals, including hospital physicians, primary care physicians, specialists including infectious disease specialists, hematologists/oncologists, pediatricians, microbiologists, specialty-trained nurses, and pharmacists working together collaboratively to enhance patient-centered care and improve outcomes. Specialists should recommend treatment options, including antimicrobials, cytoreductive therapies, leucopheresis, immunotherapy, and HCT. Pharmacists should review the indication, dosage, interactions, and contraindications of medications. Nurses taking care of these patients should monitor signs and symptoms associated with neutrophilia-related conditions and report emergent concerns to hospitalists and specialists. Thus, the morbidity and mortality related to neutrophilia-related conditions can be lowered through an interprofessional team approach.
If you or a loved one were harmed as a result of medical malpractice in Oklahoma or in another U.S. state, you should promptly consult with an Oklahoma medical malpractice attorney, or a medical malpractice attorney in your state, who may investigate your medical negligence claim for you and represent you or your loved one in a medical malpractice lawsuit, if appropriate.
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