Ms W’s final visit with Dr E was at the end of June. The patient’s symptoms would come and go, but when they came the symptoms were increasingly severe. Ms W was falling, acting intoxicated, had insomnia, and her pinky was extending outwards. Because the symptoms would wax and wane, Dr E explained again to Ms W and her mother that she believed the problems were caused by anxiety, not something neurological. Ms W and her mother asked to be sent to a neurologist or have an MRI ordered, but Dr E continued to insist that the problem was anxiety.
By the end of July, Ms W’s symptoms were so severe that she had to withdraw from her doctorate program. Her physical therapy professors had noticed her difficulties with fine motor skills and balance and had expressed concern that these were neurological.
Dr E finally ordered an MRI after Ms W demanded that or a referral to a neurologist. The MRI showed significant brain trauma which was quickly diagnosed by a neurologist as Wilson disease, a rare genetic disorder that causes an excess of copper to slowly accumulate in the vital organs.
Despite treatment to remove the excess copper, Ms W’s health continued to deteriorate to the point where she was unable to move except to blink her eyes. She remained in this condition for two and a half years, after which time she was able to make significant improvements. Even with improvements, however, she would require 24/7 supervision, and medical treatment for the rest of her life.
Ms W’s parents hired a plaintiff’s attorney and sued Dr E and the health system for negligently failing to diagnose and treat her disease.
At trial, the plaintiff had numerous experts testify about Wilson disease, and the fact that if timely diagnosed and treated, patients can live a normal, productive life. The plaintiff’s experts all faulted Dr E for her treatment, and specifically for: not taking a complete and thorough history, not looking at the patient’s prior medical records, not ordering diagnostic exams, not referring the patient for a neurological consultation, and misdiagnosing the patient as suffering from anxiety. These issues combined to delay Ms W’s treatment until her condition was too serious to be easily treated. Even the defense experts admitted that Dr E took an inadequate history of Ms W’s tremor, particularly because a unilateral tremor in a younger person can be a sign of something very serious. All of the experts similarly agreed that neither anxiety nor medication would cause unilateral tremors.
Experts testified that Ms W’s mental capacity now was that of a 12-year-old, that she would never be able to safely drive, work, or be independent, and that as she got older, her condition would continue to deteriorate.
After an hour and a half of deliberation, the jury returned a verdict for Ms W of over $28 million.
Knowing what you don’t know is sometimes as important as knowing what you do. This is why consulting with another clinician, or referring a patient to a specialist, is so essential.
Dr E failed her patient by not thoroughly investigating Ms W’s complaints, by not properly diagnosing her, and most of all, for failing to refer her to someone who could.