Kidney Infection Goes Untreated For Several Days

This case takes place in Kentucky and involves a female patient who was hospitalized following an injury sustained at home. During this hospitalization, the patient required the insertion of a Foley catheter for urinary bladder drainage. Prior to her discharge from hospital, she complained to the attending physician about pain in her sides, which the doctor attributed to the original injury. Shortly after the patient was discharged, she developed a fever, chills, sweats, and urinary frequency. During a visit with her primary care physician, several tests were run to determine the cause of these symptoms, however the results would not be available for a few days. The physician told the patient to call the office the following day if her symptoms worsened, which she did. She said that she wanted to be seen, however she was informed that there were no appointments available and was advised to wait until the results of her tests would be ready. The patient was feeling much worse at this point, and presented to the ER. Upon arrival she was diagnosed with a severe kidney infection, along with a range of other issues.

Question(s) For Expert Witness

Expert Witness Response E-004046

I have treated patients with pyelonephritis at least 100 times during my career. The issue is whether the treating physician should have appreciated the severity of the infection on May 7 and recognized that he was dealing with an upper, rather than a lower, urinary tract infection. The management described is arguably appropriate for a lower urinary tract infection. However, I believe a compelling case can be made that the treating physicians should have recognized the severity and upper tract nature of the infection earlier, in which case early institution of empiric therapy would have altered the course. Earlier institution of antibiotic therapy would have prevented the spread of the infection depending on the organism grown.

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