Legal Pearls: Missed Meningitis in a Child

A 4-and-a-half-year-old girl presented to the emergency department with a fever of 105 degrees, red, non-blanching skin lesions, and vomiting.

After examining the patient and speaking to the parents, the physician, who did not have extensive experience treating children, concluded that the child had acute gastroenteritis. He based his conclusion on the episodes of vomiting and the child’s fever.

By Monday morning, the girl’s worried parents called her regular pediatrician and described the symptoms. On the second visit to the emergency department, another physician diagnosed meningitis, which was confirmed with a lumbar puncture.

The child was given intravenous antibiotics and fluids, but her condition continued to worsen throughout the evening. She developed purpura fulminans and disseminated intravascular coagulation and both arms and legs had to be amputated. The child underwent over 20 surgeries to stabilize her condition.

Was the doctor negligent?

(Discussion on next page)