Defense Verdict In Pediatric Necrotizing Pancreatitis Case: In June 2023, a Georgia medical malpractice jury returned its verdict after four hours of deliberations and a four-day trial in favor of the defendant gastroenterologist who was the attending physician for a nine-year-old patient who went into shock due to necrotizing pancreatitis in 2018.

On February 6, 2018, the child was brought to Wellstar Paulding Hospital with severe abdominal pain and distension. The medical staff initially believed that the boy was constipated but later that evening the child was transferred to Children’s Healthcare of Atlanta’s Scottish Rite Hospital where he came under the care of the defendant gastroenterologist. Later that same day, the child went into hypovolemic shock and was transferred into the pediatric intensive care unit (PICU) where he was subsequently diagnosed with acute pancreatitis that progressed to necrotizing pancreatitis. The child’s very serious condition resulted in a four-month hospital stay during which he endured multiple surgeries and incurred medical bills in excess of $2.5 million.

The plaintiffs argued to the Georgia medical malpractice jury that the defendant gastroenterologist breached the standard of care by failing to properly monitor and treat the child for the hours before the child went into hypovolemic shock, pointing to the child’s heart rate and breathing issues and his vomiting. The plaintiffs argued that earlier diagnosis and treatment would have prevented the child’s condition from deteriorating.

The defense argued that the gastroenterologist’s belief that the child had extreme constipation was reasonable under the circumstances because the child’s non-specific symptoms were consistent with a child suffering from constipation. The defense attorney stated after the verdict: “A reasonable provider takes that history and reasonably, under these circumstances, says ‘That’s constipation’ … The only providers who actually laid hands on [the child] all thought constipation,” arguing that the child’s relatively non-specific symptoms, as well as his decreasing pain levels, “took the clinical picture away from one that was ‘classic’ for pancreatitis, as suggested early on in the trial, and allowed the jury to appreciate that Dr. Patel was working with a reasonable diagnosis until Ethan’s clinical picture deteriorated. It was a hard-fought case against great attorneys.”

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Necrotizing Pancreatitis In Children

Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain, vomiting, and an increase in pancreatic enzymes. Recent studies indicate an increase in the prevalence of acute pancreatitis in children. In the majority of cases, acute pancreatitis resolves with bowel rest and does not result in severe complications in children. It can rarely be complicated by the development of necrosis.

Necrotizing pancreatitis is very rare in children: it has been estimated that necrotizing pancreatitis occurs in less than 1% of children with acute pancreatitis. From five large pediatric series in the United States, pancreatic necrosis was observed in only 3 out of 1,014 children. There are a few case reports of necrotizing pancreatitis in children.

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