Delayed Diagnosis of Appendicitis Results in Ruptured Appendix

This case takes place in Delaware and involves a 13-year-old female with no significant past medical history. She presented to her pediatricians office with complaints of severe abdominal pain and discomfort. She was seen by a Nurse Practitioner who prescribed an adult-strength laxative, prior to ruling out appendicitis. The patient returned home and administered the laxative. Several hours later, the patient’s appendix ruptured and she was taken to the hospital. A life-threatening incident, this condition required immediate surgery to remove the appendix and clean her abdominal cavity. In addition to the immediate and acute danger, she has suffered from a host of complications as a result of the ruptured appendix.

Question(s) For Expert Witness

1. Do you have any specific knowledge on the effects of prescribing an adult-strength laxative to a pediatric patient with acute appendicitis?

2. Is it likely that this prescription aggravated the girl’s condition?

3. Have you ever treated a child with acute appendicitis / or a child who has suffered from a ruptured appendix?

Expert Witness Response E-007322

The laxative should have never been prescribed, and there are a number of reasons why. There are steps that should have been taken to ensure that this patient warranted a laxative - which clearly weren't taken - and since appendicitis wasn't ruled out, it was a dangerous decision to prescribe this young woman a laxative. The laxative obviously aggravated the appendix and caused it to rupture far sooner than it would have otherwise.