RUPTURED APPENDIX and MEDICAL NEGLIGENCE?

If this blog touches on any issue of interest to you please do not hesitate to contact us at nicholas@oshearussell.ie for some preliminary guidance and advices.

 At first sight this it may seem evident that a ruptured appendix occurring while a person is under Medical Care must amount to Medical Negligence but the position may be anything but.

There are typical symptoms that an individual presenting with appendicitis will present, however, there are equally atypical cases.

Appendicitis is probably one of the most common acute abdominal surgical conditions in medicine but diagnosis can be tricky.   Failure to diagnosis can, unfortunately, result in rupturing or perforation of the appendix.

If an appendicitis presents in classical text book fashion which it does in or about 50% of patients, diagnosis is relatively easy.   Onset of symptoms over a period of some 24 hours tend to follow the pattern as follows:-

a. feeling ill

b. generalised abdominal discomfort

c. loss of appetite.

d. nausea

e. pain in right lower quadrant of the abdomen.

f. fever

g. vomiting.

Physical examination will show tenderness in the right lower quadrant.   Simply stated if a patient presents in this way and is not diagnosed appropriately this is more likely to constitute medical negligence.

However, the other half of patients presenting do not show these typical symptoms.   This can lead to                  misdiagnosis.   Unfortunately, a relatively significant percentage of these cases can progress to perforation before an accurate diagnosis is made and, in turn, lead to emergency surgery.   There is no “gold standard rules” for diagnosis of appendicitis and even tests such as CT Scans etc. have limited use.

Medical Negligence will generally arise where the classical signs are missed or where the possibility of an appendicitis is not considered.   Indeed there have been cases of a misdiagnosis with gastroenteritis.

The likelihood of a claim succeeding is increased in the following situations:-

  • The main complaint at admission is abdominal pain.
  • The medical history taken fails to document the characteristics of the particular pain.
  • Examination fails to diagnosis areas of tenderness
  • Gastroenteritis is diagnosed in the absence of nausea, vomiting and/or diarrhea.
  • Medication is prescribed before a cause has been properly explored.
  • Appendicitis is never considered as a possible diagnosis.

A case some years back that came before the Courts and where a significant compensation was paid, shows what can happen.

The patient’s GP referred her to the Hospital with “suspected appendicitis”.   The Junior Doctor who saw her there diagnosed Gastroenteritis and discharged her without further treatment.    The patient deteriorated and presented at Accident & Emergency.   There was a misdiagnosis on this occasion of an abscess requiring laser surgery.   It was considered to be gynecological in nature.    She was moved around between Maternity and main Hospital until, finally, a diagnosis of peritonitis secondary to a perforated appendix was made and she underwent significant surgery and was left with an unsightly scar and a long recovery period.

If you need advice on this area please do not hesitate to contact our Mary O’ Shea BA, LL.B who is a specialist on Medical Negligence Claims

 

TEL: 059 9724106

www.oshearussell.ie

nicholas@oshearussell.ie

 

* A Solicitor may not charge fees or levy or any other charges as a percentage of any award or settlement.

 

 

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