Sticker shock: the high cost of legal defense; FDA update on the use of antidepressants; Duty to inform: a guide to informed consent (expired CME); Failure to diagnose meningitis; Risk management consult

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Failure to diagnose cornual pregnancy
A 33-year-old woman came to the emergency department (ED) complaining of bilateral abdominal pain, back pain, and shortness of breath.
Failure to diagnose retained sponge
A 55-year-old woman was admitted to a hospital in New Mexico for a colostomy reversal.
Failure to diagnose tuberculosis
A two-year-old boy with a five-day history of intermittent fever and stomachache was brought to his pediatrician. The child was diagnosed with a viral syndrome and treated with simethicone drops
Delay in detecting melanoma
A 58-year-old man came to his family physician for evaluation of a lesion on his back. The man was a long-time patient of this physician.

Failure to follow up on mammogram
A 54-year-old woman returned to her primary care physician, Family Physician A. The patient reported pain in her left arm, chest, and back that had continued for a week.
Failure to diagnose rhabdomyolysis
At 3:20 p.m., a 3-year-old girl was brought to the emergency department (ED) with complaints of fever, lethargy, sore throat, severe leg pain bilaterally with decreased sensation, and absent reflexes.
Failure to diagnose appendicitis
A 6-year-old boy, accompanied by his mother, came to Pediatrician A for a sick visit on October 21. The child had a five-day history of fussiness, sore throat, coughing, vomiting, stomach pain.
Failure to diagnose pneumonia
A five-year-old girl was brought by her parents to a clinic and seen by a pediatrician as a new patient. The patient came with a one-day history of fever recorded as 104.5 degrees.
Misdiagnosis of pancreatic cancer
The patient, a 36-year-old woman, had a 10-year history of a pancreatic cyst. She had two fine needle aspiration (FNA) biopsies in the previous year.
Negligent identification of biopsy tissue
After two years of finasteride therapy for benign prostatic hyperplasia, a 55-year-old man was referred to a urologist’s office.
Failure to correctly read biopsy specimen
A 50-year-old woman had a digital screening mammogram. When compared to a mammogram taken five years earlier, the new mammogram revealed possible new calcifications.
Failure to diagnose femur fracture
A 28-year-old man was involved in a motorcycle collision, sustaining multiple injuries. The man hit the side of a trailer and was thrown off his motorcycle.
Failure to evaluate patient
A 72-year-old man was evaluated by Ophthalmologist A on several occasions. The patient had cataracts, with best corrected visual acuity of 20/25 in the right eye and 20/40 in the left eye.
Failure to respond to shoulder dystocia
A 24-year-old pregnant woman began prenatal care with her OB-GYN physician at approximately 24 weeks into her pregnancy. This was the patient’s second pregnancy; her first pregnancy was aborted.
Failure to diagnose and treat dissection of the carotid artery
A 35-year-old woman delivered her third child and was discharged from the hospital two days later. Her pregnancy had been complicated by preeclampsia and gestational diabetes.
Failure to diagnose breast cancer
A 49-year-old African-American woman came to an internal medicine physician in August 2001. She continued to see this physician and his physician’s assistant for several years.
Failure to diagnose Churg-Strauss Syndrome
A 44-year-old man came to the ED with swelling of the lower extremities and ecchymosis present for the past six days. He denied nausea, vomiting, or diarrhea.
Failure to manage medications
In December 2008, a 76-year-old woman came to an internist to establish a primary care relationship and to seek treatment for itching.
Failure to properly advise patient
A 37-year-old woman of Ashkenazi Jewish descent, with a strong family history for breast cancer, had a mammogram performed as part of an annual exam.
Failure to diagnose and treat thrombosis