An allergist (also known as an immunologist) is a doctor specializing in the diagnosis, treatment, and long-term management of immune system disorders and allergies. Allergists deal with common things like allergies or asthma and complex things such as primary immunodeficiency disorders in which part or all of the immune system is not properly functioning.
Our malpractice lawyers do not see many cases involving allergists. We follow malpractice lawsuits pretty closely in Maryland and have not seen a claim against an allergist in years.
This specialty of medicine sees few malpractice lawsuits because most of their mistakes are correctable without causing the level of harm that would give rise to a medical malpractice case. Still, there are some cases where the failure to diagnose or the wrong diagnosis can cause serious injury or death to the patient.
Allergist Education and Licensing
Immunologists or allergists must obtain a medical degree from an accredited medical school. After medical school, allergists must undergo a 3-year resident training program in either pediatrics or internal medicine.
Once they complete this training, candidates must take and pass the American Board of Pediatrics or the American Board of Internal Medicine exam. Upon completing these requirements, a pediatric or internal medicine doctor can become an allergist/immunologist by completing an additional 2-year fellowship in the field.
Becoming a “board certified” allergist/immunologist is achieved by taking and passing the American Board of Allergy and Immunology certification exam.
Allergists and immunologists can further distinguish themselves by becoming a Fellow of the American Academy of Allergy, Asthma & Immunology. Allergists with this distinction will carry the “AAAI” designation after the “M.D.” in their credentials.
What Do Allergists and Immunologists Do?
Allergists/immunologists are primarily found in private solo or small group practices, which receive patients on referrals from primary care doctors.
Most of what allergists and immunologists do involves outpatient care and treatment instead of hospital work. Many allergists and immunologists can also be found working in the research and development field.
Allergists and immunologists are generally engaged in diagnosing, treating, and managing children and adult patients with certain types of allergies and immune conditions, such as:
- Asthma, sinusitis, occupational lung problems, rhinitis, and other diseases and disorders involving the respiratory tract
- Skin allergies like dermatitis, urticaria, and angioedema
- Adverse allergic reactions to foods, medicines, vaccines, insect stings, and other substances
- Immune system diseases like primary immune deficiency, combination immune deficiency syndromes, antibody deficiencies, phagocytic cell problems, and acquired immune deficiency (AIDS) from HIV.
- Autoimmune response diseases or auto-inflammatory conditions
- Systemic disorders involving mast cells or eosinophils
- Bone marrow and organ transplantation
Malpractice Lawsuits Against Allergists and Immunologists
Compared to other types of doctors, allergists, and immunologists don’t get sued for medical malpractice very often. This does not mean allergists make fewer mistakes or errors than other doctors. Allergists are human and make mistakes like everyone else in the medical profession. The main difference is that mistakes by allergists or immunologists are less likely to have devastating consequences for the patient.
Allergists don’t have to defend many malpractice cases because they have a much wider margin for error than other specialties. For example, if a surgeon makes even a tiny mistake during a procedure (such as cutting too deep), it can have disastrous results. Therefore the victim of that surgical error is much more likely to sue the surgeon for medical malpractice. By contrast, even if an allergist makes a huge mistake, it usually won’t cause major harm to the patient.
Medication Error Lawsuits
Medication error is also a possible form of malpractice for allergists. First, it is a deviation from the standard of care to knowingly administer medication to which the patient is allergic. There are also allergist lawsuits and settlements involving allergy shots gone wrong. For example, an allergist in Chicago caused a patient to go into anaphylactic shock after giving an allergy shot that was 3,000 times the proper dose. The patient died, and the allergist paid $1.5 million to settle the wrongful death lawsuit.
We also see allergist malpractice cases involving:
- Allopurinol prescriptions causing Stevens-Johnson Syndrome
- The patient suffered anaphylaxis to Ancef (Cefazolin), which should have been predicted based on the patient’s history of penicillin allergy or other allergy.
- There are also claims against allergists when they act as internists. Even though the allergists focus on their area of specialty, they are also trained as internists and are held to the standard of care which applies to internal medicine. Patients come to an allergist and bring up issues that an internist would address, and the allergist often addresses them.
- Prescribing a drug like Albuterol or other inhalants without first obtaining a cardiology consultation with an at-risk patient.
Failure to Diagnose Lawsuits
Errors in diagnosis consistently rank among the primary reasons for malpractice lawsuits, and allergists often make these mistakes.
When an allergist or immunologist breaches the standard of medical care, it often involves some type of diagnosis error or failure to diagnose claim. Allergists are supposed to diagnose allergies. If an allergist tells a patient that they are not allergic when they actually are, it can sometimes lead to unfortunate results.
One notable example of how this sort of diagnostic failure can go terribly wrong occurred in Seattle. The allergist advised the patient that he was not allergic to bee stings (based on a negative skin test). Based on this, the patient opted not to get treatment and stop carrying his epi-pen. It turns out he was very allergic to bee stings and had a severe allergic reaction after being stung by a yellow jacket. The reaction left him with permanent brain damage, and he ended up getting $5 million in his malpractice claim against the allergist.
Another classic misdiagnosis case is failing to diagnose a shellfish allergy, usually in teenagers. For example, a child, unaware of their lethal allergy, goes into anaphylactic shock after consuming shrimp at a friend’s party.
Shellfish allergies can intensify over time with repeated exposure, perhaps initially manifesting as a minor skin reaction that leads you to seek medical advice, resulting in an allergist’s referral—the allergist’s job is to test. If the allergist does not test or tests improperly, it can lead to tragic results if the allergist misses diagnosing the shellfish allergy and the teenager experiences a severe, oxygen-depriving reaction. The same holds for peanut allergies which is another common misdiagnosis.
Emerging Challenges in Allergist Practice
Allergists and immunologists are navigating a landscape fraught with emerging challenges, particularly in the realm of potential malpractice liability. One critical issue is the rising incidence of complex allergic conditions, exacerbated by environmental factors and shifting lifestyles.
These circumstances heighten the need for allergists to employ advanced diagnostic tools and treatments to effectively manage severe allergies and atypical immune responses.
Moreover, the integration of precision medicine presents new complexities. As personalized healthcare gains prominence, allergists must stay abreast of genetic predispositions and individual immune profiles, ensuring thorough assessments to avoid misdiagnosis pitfalls that could lead to malpractice claims.
Best Practices for Allergists to Mitigate Malpractice Risks
While allergists experience fewer malpractice suits compared to other medical specialties – because, frankly, they are less likely to be in a position where mistakes cause permanent injuries – proactive measures are essential to safeguard against potential claims.
Rigorous diagnostic protocols are paramount, involving comprehensive patient histories, validated allergy testing methods, and meticulous follow-up procedures to minimize the risk of misdiagnosis. Equally crucial is informed consent processes.
Most but not all allergists understand that informed consent is not optional. By thoroughly educating patients about treatment options, potential risks, and the necessity of emergency preparedness, allergists empower patients to make informed decisions, thereby reducing the likelihood of malpractice allegations. These strategies keep patients safe and prevent allergist malpractice lawsuits in the first place.
Allergist Verdicts and Settlements
Below are a few more verdicts and reported settlements from medical malpractice lawsuits against allergists or immunologists. Obviously, there are not many which underscore how rarely these doctors are sued.
- New Jersey – $7.6 million: A 38-year-old woman was seeing an allergist to treat constant and excessive nasal discharge. She initially sought treatment from an ENT but was eventually referred to the defendant allergist. Allergist saw her several times, and initial allergy testing returned negative, so he advised her that further allergy tests should be performed in several months. Hours after her appointment, she ends up in the hospital with severe headaches. At this point, it was determined that it was cerebral spinal fluid leaking from her nose, and diagnose bacterial meningitis. Plaintiff goes into a coma for two weeks and remains in the hospital for another four months. She is left with severe and permanent brain damage resulting in cognitive deficits and memory loss. She sues the allergist claiming that he was negligent in failing to consider a cerebral spinal fluid leak as a differential diagnosis which would have revealed her condition. Jury awards a $7.6 million payout.
- Massachusetts – $440,000: Plaintiff went to an allergist’s office for the usual allergy shot. After receiving the shot, she began to exhibit signs of an adverse allergic reaction, so the allergist gives her Benadryl. Her condition worsens; she falls into respiratory and cardiac arrest and eventually dies. Her husband brings wrongful death action against the allergist, alleging that his response to her sudden reaction was negligent and that he should have administered oxygen and an epinephrine shot immediately. The case was settled for $440,000.
- Indiana – $484,000: Male plaintiff in his late 30s was referred to defendant allergist for treatment of severe skin irritation causing hive-like blisters on his hands, legs, and feet. The allergist gave him a prescription for a corticosteroid drug called prednisone. Plaintiff had a severe reaction to the Prednisone that caused necrosis of his hip joints, and he eventually had to undergo bilateral. He sued the allergist for medical malpractice, and the case settled for $484k.
- Virginia – $700,000: 33-year-old male plaintiff went to the defendant allergist’s office for a heavy-duty allergy injection after severe allergies sent him to the emergency room on two separate occasions with difficulty breathing. The allergist inappropriately gave him the injection of Susphrine intramuscularly rather than subcutaneously. The following day the plaintiff had severe pain in his arm and went to the hospital. His arm had to be amputated, and he sued the allergist for negligent administration of the injection. The case was settled for $700k.
- Oregon – $296,254: 10-year-old girl went to the defendant allergist after experiencing shortness of breath while playing soccer. Allergist diagnosed her with exercise-induced asthma and prescribed inhalers. The inhalers were ineffective, but the allergist maintained his diagnosis. Soon after, the girl suffered an acute myocardial infarction while exercising and died. It was then discovered that she did not have asthma but rather a congenital abnormality in her coronary artery which caused her death. Her parents sued the allergist for misdiagnosis. The case settled out of court for $296k.
Contact Miller & Zois about Allergist or Immunologist Malpractice
If you think you may have a medical malpractice case against an immunologist or allergist, contact the malpractice attorneys at Miller & Zois at 800-553-8082 or contact us online.