Clinical AdvisorClinic Liable for $27 Million After PA Misdiagnosed Meningitis as Influenza

A Pennsylvania urgent care clinic faces a $27 million verdict after a physician assistant misdiagnosed bacterial meningitis as influenza, resulting in severe complications for the patient. The case highlights critical considerations in differential diagnosis, particularly when symptoms overlap between conditions, and emphasizes the importance of ruling out serious conditions before settling on common illnesses

Key Points:

• The patient presented with fever (103°F), dizziness, confusion, agitation, and elevated respiration and pulse. Despite a negative influenza test, the PA diagnosed influenza based on symptoms and seasonal prevalence.
• The patient’s condition deteriorated over two days, leading to hospitalization where he was diagnosed with acute bacterial meningitis. Complications included three strokes, brain damage, permanent hearing loss in the right ear, and nerve damage affecting mobility.
• Defense argued the diagnosis was reasonable due to the absence of severe head and neck pain typically associated with meningitis. The PA testified to ruling out meningitis on this basis.
• The jury awarded $27 million – exceeding the plaintiff’s initial $25 million settlement request. The defense had offered $250,000 to settle one week before trial.
• Patient outcomes included months of rehabilitation to relearn basic functions including walking, talking, feeding, and bathing.

HCN Medical Memo
This case reinforces the principle of ruling out serious conditions before defaulting to common seasonal illnesses, particularly when patients present with atypical symptoms or negative test results.

Differential Diagnosis Summaries