Internal Medicine, Ophthalmology
Ref. # 10438
A 71-year-old man was diagnosed with polymalgia rheumatica in 1989 and maintained on a low dose of steroids. In 1992 the patient complained of severe headaches, which continued for one year. A CT scan was normal. In 1993 the patient complained of jaw pain in addition to the headaches. He was referred to an ophthalmologist, who scheduled a biopsy for the following week. The patient lost all vision in the left eye the day before the biopsy, which was consistent with temporal arteritis. A medQuest internist reported negligence on the part of two internists: the first failed to diagnose the temporal arteritis; the second failed to increase the steroid dosage. A medQuest ophthalmologist reported that the patient's doctors, including the ophthalmologist, all seemed to suspect temporal arteritis but negligently failed to treat it in a timely manner.