Medical Malpractice — Bacterial Meningitis

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Meningitis also known as spinal meningitis is an infection of the spinal fluid causing inflammation of the tissues (the meninges) that line and surround the brain and spinal cord. It is a disease that appears in two distinct forms: Bacterial meningitis and Viral meningitis.

  1. Viral meningitis is the more common and far less mild form of the disease. Also known as aseptic meningitis, it usually clears up within a couple of weeks and usually leaves no permanent damage.
  2. Bacterial Meningitis is a serious infection requiring immediate medical care. The most common victims of spinal meningitis are babies and toddlers from birth to two years old, who account for approximately two-thirds of the annual 10,000 -25,000 cases of the disease. Bacterial meningitis causes death in about 10% of its patients, often within hours of onset of symptoms. The disease can kill an infant in 24 hours if left untreated.

Consequences of Bacterial Meningitis

Without immediate and proper diagnosis and treatment, bacterial meningitis can result in long-term and permanent complications including:

  1. Blindness
  2. Brain Damage
  3. Coma
  4. Deafness
  5. Death
  6. Learning Disabilities
  7. Mental Retardation
  8. Other Disabilities
  9. Paralysis
  10. Seizures
  11. Shock

Much of this needless damage is a result of delay in diagnosis, improper diagnosis and/or improper treatment.

About Bacterial Meningitis

Bacterial meningitis is caused by several strains of bacteria, including Group B strep (in newborns), hemophilus influenzae Type B (in babies), meningococcus (young adults) and pneumococcus (adults). These strains of bacteria account for over 80% of bacterial meningitis cases in the U.S. Bacterial meningitis is contagious and can spread from person to person through coughing and sneezing.

Between 10,000 and 25,000 children contract bacterial meningitis each year. Bacterial meningitis requires immediate treatment with very powerful antibiotics. The longer the delay in administering antibiotics, the more severe their complications will be. If immediately and aggressively treated with powerful antibiotics, bacterial meningitis is curable and long-term damage can be avoided. Unfortunately, almost 500 people, mostly children, die from bacterial meningitis each year.

Common Symptoms of Bacterial Meningitis

Bacterial meningitis can be challenging to diagnose. Its symptoms mimic those of a bad flu, and there is no real way to know for certain if meningitis is present without a lumbar puncture (spinal tap). Delay in diagnosis and treatment can be the difference between life and death (especially in infants and young children) and can result in brain damage, coma, hearing loss, mental retardation, paralysis, seizures and death.

Bacterial meningitis can present in many ways. Sometimes it is a slowly progressing disease. Other times, it can strike in hours. Bacterial meningitis commonly begins in the ears, sinuses or throat and then spreads. Fever is a common sign, but can be tricky because bacterial meningitis doesn’t always present with fever, and of course many other childhood illnesses do. Other symptoms may include drowsiness, confusion, headaches, or vomiting. Meningitis can cause seizures. It can cause irritability, and a lack of appetite. In young babies, the soft spot on the top of the head may become hard and bulge out. After the first year or so, it can also create a stiff neck. Confusion may be present in older children. Symptoms vary widely, depending on age.

For infants and babies, they might include:

  1. Fever
  2. Cold hands and feet
  3. Neck retraction with arching of back
  4. Refusing food
  5. Vomiting
  6. Diarrhea
  7. High pitched cry or whimpering
  8. Difficult to wake or lethargic
  9. Dislike of being handled
  10. Pale blotchy complexion

For older children and adults, symptoms may include:

  1. Vomiting
  2. Fever
  3. Headache
  4. Stiff neck
  5. Sensitivity or aversion to light
  6. Drowsiness
  7. Joint pain

Diagnosing Bacterial Meningitis

Because time is of the essence in bacterial meningitis, rapid diagnosis of the condition is critical. The most foolproof method of diagnosis is a lumbar puncture, commonly known as a spinal tap. Examination of the spinal fluid will immediately confirm or rule out the presence of the signature bacteria.

Treatment of Bacterial Meningitis

The infection is treated with powerful antibiotics.

Why is Malpractice An Issue with Bacterial Meningitis?

A doctor’s delay or failure to diagnose bacterial meningitis (especially pediatric bacterial meningitis) can have dire consequences. Failure to treat the disease in a timely manner significantly reduces the changes of survival and significantly increases the chances of permanent damage if the patient does survive. Failure to diagnose the condition, order the appropriate test (spinal tap/lumbar puncture) and failure to begin immediate administration of antibiotics to kill the infection before permanent damage is done, are often instances of medical negligence, medical incompetence, or medical malpractice.

Some of the saddest and — unfortunately — most common stories of severe and lasting damage and/or death from bacterial meningitis involve babies and toddlers being taken to the pediatrician with a significant fever and the doctor dismissing it as a minor viral infection, when in fact an acute bacterial infection is raging through the child’s body. Days later the baby shows up in the emergency room with an even higher fever and/or seizures and is diagnosed — too late — with meningitis. If the child lives, blindness, heart damage, brain damage and other permanent and life-damaging injuries often result.

Delay in diagnosis and delay in starting powerful and immediate antibiotic therapy can make an enormous difference in outcome, damage and survival rate of bacterial meningitis. This is why it is incumbent upon doctors, pediatricians and emergency room personnel to recognize the signs and symptoms of bacterial meningitis and know how to respond quickly and effectively.

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