Facts

Plaintiff David Wanderley, a high school senior at the time, presented on Oct. 29, 2003 to defendant Kaiser Imperial after hours clinic with abdominal complaints of pain and vomiting. The patient was seen by Rocio Perez, M.D., a board certified pediatrician, who performed a history and a physical. The patient reported eating Taco Bell three days earlier and developing pain, followed by vomiting the next morning. He continued to have complaints since then. Examination of the abdomen was benign and the diagnosis of acute gastroenteritis was made. The patient was discharged home with no follow-up instructions.

The patient returned to a Kaiser ER on Oct. 31, 2003 and was immediately diagnosed with acute perforated appendicitis. The patient underwent emergency appendectomy surgery and remained in the hospital for about a week thereafter. He returned eight days later for re-exploration surgery to drain and remove an abdominal abscess at the site, and again remained in the hospital for a week. He returned again about two months later with a small bowel obstruction, which was treated by nasogastric tube suctioning, again requiring a week's admission to the hospital. After suffering a loss of 40 pounds and being put on bed rest for several months, the patient ultimately fully recovered to near total capacity.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended that Dr. Perez fell below the standard of care in her history taking and physical examination of the plaintiff, resulting in a missed diagnosis. The plaintiff contended that Dr. Perez failed to appreciate the importance of a history of pain proceeding vomiting and also failed to perform certain physical diagnostic tests.

The plaintiff claimed physical pain and suffering over several months, including severe weight loss, weeks of hospitalization, loss of strength and energy, as well as missing several months of his senior year. The plaintiff contended that had the diagnosis been made on Oct. 29, the appendix could have been removed laparoscopically, the appendix would not have perforated and all of the sequelae of the abdominal abscess, small bowel obstruction, and post-surgical adhesions would have been avoided. The plaintiff contended that he remains with significant abdominal problems secondary to adhesions which are a natural consequence of surgery.

DEFENDANTS' CONTENTIONS:
The defendants contended that Dr. Perez' history and physical examination of the patient was complete, appropriate, and within the standard of care. The defendants contended that neither the history of the patient's illness nor the physical examination reasonably suggested a possibility of appendicitis. The defendants further contended that the pathology from the appendectomy showed a walled off appendix, which made the diagnosis all the more difficult. The defendants finally contended that even if the appendectomy surgery had been performed on Oct. 29, the sequelae likely would have been the same, as the scenario of events suggests that the patient had perforated by then.

Settlement Discussions

$100,000 demand. No offer.

Injuries

The plaintiff claimed physical pain and suffering over several months, including severe weight loss, weeks of hospitalization, loss of strength and energy, as well as missing several months of his senior year. The plaintiff contended that had the diagnosis been made on Oct. 29, the appendix could have been removed laparoscopically, the appendix would not have perforated and all of the sequelae of the abdominal abscess, small bowel obstruction, and post-surgical adhesions would have been avoided. The plaintiff contended that he remains with significant abdominal problems secondary to adhesions which are a natural consequence of surgery. DEFENDANTS' CONTENTIONS: The defendants contended that Dr. Perez' history and physical examination of the patient was complete, appropriate, adn within the standard of care. The defendants contended that neither the history of the patient's illness nor the physical examination reasonably suggested a possibility of appendicitis. The defendants further contended that the pathology from the appendectomy showed a walled off appendix, which made the diagnosis all the more difficult. The defendants finally contended that even if the appendectomy surgery had been performed on Oct. 29, the sequelae likely would have been the same, as the scenario of events suggests taht the patient had perforated by then.

Result

Defense award. The arbitrator was Robert Northup, Esq.