Flores v. Kaiser Foundation Health Plan
This is an emergency room failure to diagnose sepsis medical malpractice case filed on by a woman in Montgomery County who tragically underwent bilateral above knees and above wrists amputations. This case was filed in Health Claims Arbitration on August 17, 2016, and it is the 407th medical malpractice case filed in 2016 in Maryland.
Summary of Plaintiff’s Allegations
Plaintiff goes to Kaiser Permanente, Kensington Center with complaints of congestion, yellow phlegm, loss of her voice, and a cough that she has had for two weeks. She tells the doctors that she is unable to sleep at night and that over the counter medicines are not helping her. She is diagnosed with bronchitis and laryngitis and is given an antibiotic, azithromycin, to take for four days.
A month and a half later, her symptoms still are present. She goes to defendant doctor. Her systems are the same as the first visit, except worse – continued cough, fever, sore throat, sinus pressure, headaches, post-nasal drip, and body aches. She has a low-grade fever, tachycardia, and hypotension. These signs in a patient with a known or suspected infection are indicative of systemic inflammatory changes, and should signal a more thorough assessment. However, defendant providers do not assess her respiratory rate, her oxygen saturation, do not order a CBC, and do not order chest x-rays.
Plaintiff’s medical malpractice lawyer alleges that if these steps had been taken, it would become clear to defendants that she was fighting a more severe infection. More significantly, it takes another visit two days later for defendants to transfer her to the hospital. At this visit she has diarrhea, vomiting, she is febrile, has low oxygen saturation levels, has trouble breathing, and has a white blood count consistent with sepsis.
By the time she arrives at Holy Cross Hospital, the plaintiff is extremely hypoxic and she is diagnosed with septic shock and multi-organ failure. Her chest x-rays suggest pneumonia, and laboratory tests are consistent with renal failure, lactic acidosis, and metabolic acidosis. Blood cultures confirm Streptococcus pyogenes infection, and she develops peripheral ischemia to her arms and legs from vasoconstriction secondary to medication given to her.
She is transferred to the University of Maryland for possible extracorporeal life support (ECMO). As a result of her peripheral ischemia, the plaintiff has to undergo bilateral above-knee amputations and bilateral above-wrist amputations.
Additional Comments
- The injuries in this case are brutal and the future care costs may dwarf Maryland’s malpractice cap on noneconomic damages.
- The plaintiff was probably not misdiagnosed with sepsis. Pneumonia can cause sepsis.
- It is hard to imagine an expert arguing that doing lab tests were not what the standard of care required.
- This case is likely to be fought on causation. You can expect Kaiser to argue that when she returned a month-and-a-half later, the die had already been cast. This is a tough argument to make.
- Kaiser has a history of settling medical malpractice cases. Now their defense lawyers are talking about changing that reputation and letting more cases go to trial. Still, you can bet this case will reach an out-of-court settlement before these parties see Montgomery County Courthouse steps.
Jurisdiction
- Montgomery County
Defendants
- Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
- Internal medicine doctor
Hospitals Where Patient was Treated
- Holy Cross Hospital
- University of Maryland
Negligence
- Failure to appreciate plaintiff manifested signs and symptoms of a bacterial infection
- Failure to perform tests and examinations including radiologic studies to assess the nature of the infection
- Failure to order and administer antibiotics
- Failure to have the plaintiff admitted to the hospital
Specific Counts Pled
- Negligence
- Informed consent
Plaintiff’s Experts and Areas of Specialty
- Terrance Baker, M.D. – board certified in family medicine, geriatric medicine,&emergency medicine
Getting a Lawyer for Your Malpractice Claim
More Malpractice Claim Information
- Take a look at sepsis verdicts (and settlements) to better understand the value of these cases
- Malpractice settlement values generally
- Another lawsuit filed against Kaiser in 2017 claiming Kaiser did not adequately protect patients from a doctor who was committing sexual assault and battery