Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition
2 yo female presented to ER with fever and vomiting for 1 week. Chest x-ray was ordered with an incidental finding of a button batteryfound to be lodged in the thoracic inlet. The battery was estimated to be lodged in place for approximately 5-7 days. ENT was consultedand surgically removed the battery. Significant mucosal erosion was noted. The child was admitted and an attempt at a barium swallowwas made but the child could not swallow the needed contrast. The exam did show no evidence of esophageal perforation and the babywas discharged. The child returned on August 19, 2012 with fever. CXR was clear. Viral syndrome was diagnosed due to fever andcough. She was discharged. The child returned to the ER that night as the child was crying and had neck pain. Lumbar puncture andseveral labs were performed. No neck pain on flexion was noted. The child was discharged with a diagnosis of viral syndrome. The childreturned to the ER on August 21, 2012 with continued fever. Her respirations were unlabored and she had clear lung sounds. She wasalert, playful and in no acute distress. Neck was supple. Further testing included throat culture, UA and x-rays, all of which werenegative. On August 22, 2012, the child returned via EMS unconscious and vomiting blood resulting from late onset of complicationsfrom the battery ingestion. EGD and other tests were completed. Diagnoses showed acute esophageal ulcer with perforation, gastric ulcerwith hemorrhage, hemorrhagic shock. Shortly after admission, the child coded and expired. Cause of death was exsanguination due toerosion of the common carotid artery through a carotid esophageal fistula that had formed due to a chemical alkaline battery burn.
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury
Diagnostic testing as noted above.
Diagnostic Code :
Misdiagnosis Made, If Any, Of Patient's Actual Condition
Principal Injury Giving Rise To The Claim
The child expired due to complications from button battery ingestion. Allegations included failure to consider the child's past historynoted in her medical records, failure to order imaging including CT of the neck and esophagus,
Severity Of Injury
Florida Office of Insurance Regulation Medical Malpractice Closed Claims Report