Case Archive

Family Practice, Otolaryngology
Ref. # 42118

A 69 year old Michigan woman presented to her family physician complaining of several days of flu-like symptoms, including back and leg pain, long-lasting headaches involving both temples, and a swelling in her face. The F.P.'s first written note referred to testing for temporal arteritis by running an ESR, which was not done. Medication consisted of Cefzol and Entex for otitis and rhinitis. Three days later the F.P. received a lab report which showed the patient's sed rate was 111. The F.P. referred the patient to an ENT for possible temporal arteritis. Another three days later, the ENT examined the patient and diagnosed only a local infection, making a biopsy unnecessary. One week later the patient presented to the ER with vision impairment. An attending ophthalmologist placed her on steroids and ordered a biopsy, which confirmed temporal arteritis. The woman requires ongoing prednisone therapy and is legally blind in one eye. A medQuest family practitioner opined the patient's F.P. made the difficult diagnosis but then negligently mismanaged the treatment, which should have included starting the patient on steroids. A medQuest ENT opined that both the ENT and F.P. negligently failed to respond to the patient's abnormal sed rates and refer her to an appropriate specialist. With timely diagnosis and treatment, the woman's blindness would have been prevented.

2003 -. All Rights Reserved