Missed diagnosis: 37 days to find a coin stuck in toddler’s throat

20161123150000, Chan Mei Yen
The penny had caused two large ulcers in the toddler’s throat by the time a correct diagnosis was made
In June, Samantha Knox noticed something was amiss when her previously cheerful son, E.J. became listless and withdrawn. He also developed a fever and a rash on his abdomen.

She felt her concerns were dismissed throughout multiple visits to HealthCare Partners, despite voicing her worry of E.J.’s worsening condition and requesting for more investigations to be done. She says he was diagnosed with a viral infection each time.

Mother knows best

“They weren't valuing my instincts as a mother, me knowing my son, me having carried this child in my womb,” Knox said. "I was diligent, I was committed to ensuring that my son’s health was my highest priority and I didn’t feel as though anybody else considered those facts.”

After more than a month of watching her eight-month-old suffer, a visit to Miller Children’s Hospital in Long Beach finally reveals a penny lodged in her son’s throat. Based on corrosion of the penny, specialists think it has been in his oesophagus for at least three weeks.

“When they gave me the news, I immediately started crying. This very small object could’ve potentially been the worst outcome for my son.”

The penny was found to be the cause of his symptoms and had caused two large ulcers in E.J.’s throat. The operation to remove the penny was successful and baby E.J. is now fine.

Knox is claiming medical malpractice as she believes her son’s suffering had been unnecessarily prolonged because of her doctors’ negligence and failure to perform an X-ray.

She garnered 85,000 supporters in her petition for healthcare providers to take responsibility for medical negligence and misdiagnosis, although she was denied by HealthCare Partners. The Medical Board of California intends to investigate the case further.

Atypical presentations of common conditions

While foreign bodies lodged in a child’s throat commonly lead to choking, drooling, trouble breathing, coughing, or noisy breathing, it also true that nothing in medicine is set in stone. Knox’s case is an example that a coin stuck in a child’s throat can present itself in atypical ways.

In a statement, HealthCare Partners stated, “Anytime a patient brings a concern to our attention we examine the facts surrounding the issue. There are times however when a claim simply does not align with the facts.”

When conditions present themselves through atypical symptoms, the line between helping and doing no harm becomes blurred for the doctor, when a wrong decision can land them in a lawsuit.

Defensive medicine in the face of lawsuits

Just a few months earlier, a Singaporean general practitioner was suspended for failing to diagnose his patient’s glaucoma. Among other cases, missed diagnoses constitute a large bulk of the worst medical malpractice suits, and doctors are increasingly pressured into practicing medicine in more defensive ways.

Physicians face the possibility of being sued for not ordering a test, as in Knox’s case. However, over-ordering unnecessary tests is impractical and can become costly over time.

Just as how analysing medical malpractice suits of misdiagnosis allowed greater awareness that women tend to present with atypical heart attack symptoms, analysing medical malpractice suits can contribute to the overall improvement of medical practice. MIMS

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Sources:
http://losangeles.cbslocal.com/2016/11/17/mother-doctors-failed-to-figure-out-coin-was-lodged-in-boys-throat-for-more-than-a-month/
http://ktla.com/2016/11/17/long-beach-mother-claims-malpractice-after-providers-ignored-symptoms-of-8-month-old-boy-with-penny-stuck-in-esophagus/
http://ijr.com/2016/11/739530-mom-watches-baby-change-doctors-take-37-days-figuring-out-why-after-symptoms-never-point-to-what-was-really-wrong/