- I agree. I don't think I have the whole picture cause I just can not think of
a defense.. I wanted to run it by you to see if I was missing anything.. I
guess I am not missing the fact that I am missing alot of the facts <g>
In a message dated 1/13/2004 9:04:32 AM Eastern Standard Time,
From your description, it does not seem that anyone was very proactive in
making this diagnosis, but I doubt you're giving us the whole picture because
there are many things I look at in such cases which are omitted.
I'd be interested in seeing the ER's headache protocol, for one thing and
comparing that with what was actually done. Headache can be a very difficult
diagnosis and associated with a million other disease processes. On the other
hand, because of the potential that headache is indicative of a serious process,
it deserves a fairly high triage and diagnostic level of attention.
Was a lumbar puncture done at any time during her visits?
What were her lab values (SMA-21, etc.)?
Was a sedimentation rate done?
Was a CT scan ever offered and refused?
What, if any, neurological symptoms did she have?
none until it was too late except the edema
Second, I'd be interested in how she responded to the medications given. I'd
be interested in whether hospitalization was ever offered and refused as
often happens after the patient has had pain mitigated with medications.
Third, I'd be interested in knowing how the patient's current symptoms
correlated with the previous diagnosis of migraine which WAS made in conjunction
with CT scan a year earlier.
Fourth, vasculitis would not likely have been diagnosed simply by brain CT
scan. A biopsy is almost always required to make the diagnosis.
Fifth, how early could the diagnosis realistically have been made and what
treatment modalities would have been available AT THAT TIME? For instance,
there is a very narrow "window" when certain therapies can be undertaken with any
reasonable hope of success and the question is whether the delay in diagnosis
delayed treatment in a proximally causative way relative to the patient's
There's just too much left out here to "guess" what the facility's defense
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