Resourceful Lawyer Podcast: a Litigator's Life.
Society & Culture:Personal Journals
Episode 15: Doctor misdiagnoses patient's anemia. How I took down expert with medical literature.
Craig describes a past case where he had to depose a defense expert who was extremely well. qualified and credentialed. His CV was 100 pages long and was filled with accolades, publications, and important positions. He had testified before Congress. He was the head of a national organism for Family Medicine physicians. He was a supervisor for the organization's peer review monthly publication. And he defended the conduct of the defendant doctor who Craig Steger had sued in a medical malpractice case. So how did Craig cross examine the doctor and show the weaknesses of his opinions? By confronting him with medical literature in the publication he supervises. The case involved a patient with a host of different symptoms of illness, including night sweats, weakness, chills, nausea, unexplained weight loss, body fatigue, but with no documented fever. He had a constellation of symptoms of illness, including elevated white blood count (WBC), leukocytosis, elevated sedimentation rate (sed rate), elected C-reactive protein (CRP), and other markers of inflammation. A major issue he had was severe anemia, which was suspected of being iron deficiency anemia (IDA) based on certain blood tests, which was indicative of an abdominal or digestive bleed, such as colon cancer. Other markers, however, were indicative of anemia of chronic disease (ACD), which results from the body's response to systemic infection, such as bacterial infection, as it attempts to starve the pathogen, bacteria, or other organism, of iron, and can look similar to iron deficiency anemia. The critical marker of IDA is a ferritin level less than 100, but this patient had a very high ferritin level, which generally rules out IDA and requires the physician to consider other explanations for the anemia, which would include anemia of chronic disease. This would call for a further workup, including tests such as blood cultures, which were not ordered in this case. The patient did, in fact, have a bacterial infection, which went undiagnosed, and led to sepsis, shock and a life threatening condition which resulted in a leg amputation from embolism (emboli). #podcast #lawyersofyoutube #medical #medicalmalpractice #anemia #anemiaproblems #anemiaofchronicdisease #irondeficiency #irondeficiencyanemia #bloodculture #infection #bacterialdiseases #bactermia #ferritin #familymedicine #physicianassistant #colonoscopy #differentialdiagnosis #ironsupplements #medicalnegligence #expert #medicalliterature #peerreview #personalinjury #lawsuit #jury #verdict #malpractice #wisconsin #minnesota #iowa #Wisconsinmedicalmalpracticeattorney #minnesotamedicalmalpracticeattorney #iowamedicalmalpracticeattorney #deposition #bloodtests #bloodculture #inflammation #chronicdisease #unknowninfection #infection #fever #feverofunknown
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