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In June of 2016 a previously healthy 3-year-old little girl presented to Cardinal Glennon emergency room with complaints of stomach pain, multiple episodes of diarrhea, fever and elevated vitals. She was discharged about 2 hours later without any diagnostic testing or differential diagnosis, given ibuprofen, and sent home. Her symptoms got worse, and the next evening mom noticed blood in her daughter’s diarrhea. The mother immediately made an appointment, and the next morning brought her child to see her primary care nurse practitioner in the pediatric clinic also located at Cardinal Glennon. The nurse practitioner was an employee of St. Louis University.

The little girl presented with symptoms of blood in her stool, dry mouth, nausea, dehydration and weight loss. A stool culture was ordered to test for a specific deadly strain of E. coli, known as E. Coli O157:H7 with shiga toxins. This strain of E. Coli O157:H7 is the most common cause of bloody diarrhea in children, and it carries the potential to cause kidney failure and a deadly syndrome called Hemolytic Uremic Syndrome. Rather than admitting the child for observation, monitoring and supportive care, she was given pedialyte and Tylenol and sent home. They were told the test results could take up to 48 hours to come back, and to return to the hospital if the symptoms worsened.

About 3 hours later, the mother called the pediatric clinic frantic. She said that her child’s symptoms had worsened, she was lethargic, she was now vomiting, had no urine output, and the diarrhea was continuing. The nurse practitioner told mom to take her child back to the ER.

Mom and child arrived at the hospital’s emergency room a few hours later. It was their third visit to the hospital in 48 hours. The symptoms were getting worse and she was severely dehydrated. She was vomiting. She was defecating blood. She was having to go diarrhea every 10 minutes. She was severely dehydrated. She was finally evaluated by a physician, who was also an employee of St. Louis University. The physician knew that this was the family’s third time to the hospital. He knew that oral hydration had failed for the worsening dehydration. And he knew that test results were pending that were done specifically because the deadly strain of E. Coli was suspected. Yet he did not admit the child to the hospital for monitoring and treatment. Instead, he provided her with intravenous fluids, diagnosed her with the stomach flu, and sent her home. He also ordered and got the results of blood testing, which Plaintiff argued contained evidence of a hemolytic process.

36 hours later, Plaintiff’s father found her lifeless on the floor in a pool of bloody diarrhea. Without getting dressed, he drove her back to the hospital. She was finally admitted, where she would remain for 3-months. Upon admission, she was diagnosed with an acute kidney injury secondary to dehydration. The test results finally came back that afternoon positive for E. Coli O157:H7 + Shiga-Like Toxin.

During her hospital stay, the child developed a host of complications, including kidney failure, seizures, neurological failure, and diabetes. She will permanently be an insulin dependent diabetic with high blood pressure, kidney disease, with cognitive injury. The injuries she sustained required her to undergo intensive rehabilitation, chronic dialysis, and a lifetime of kidney transplants and hospitalization.

Plaintiff alleged that Defendant was negligent in failing to admit the child to the hospital for proper monitoring and supportive care, most importantly to keep her hydrated. Plaintiff presented expert testimony that had she been admitted and provided with supportive care in the form of monitoring, intravenous hydration, and as needed dialysis, she would not have any of the permanent injuries that she suffers from today.

Defendant disputed liability and causation, arguing that they could not get the culture results back quicker, and as such they provided adequate care and treatment for dehydration in line with CDC guidelines, and that upon discharge each time Plaintiff was stable and looking better. Moreover, Defendant argued that even if they had admitted her, the outcome for this disease caused by this strain of E. Coli would have been the same. In sum, Defendant argued that the child was simply unlucky to have contracted such a terrible, rare, aggressive disease with no known cure.

The Defendant in the case was St. Louis University, since it employed the nurse practitioner and physician who treated Plaintiff. After an 8 day trial in St. Louis City, 9 of 12 jurors found in favor of the plaintiff, awarding a total of $18,254,033.00. The Plaintiff was represented by John Simon, Tim Cronin and Johnny Simon of The Simon Law Firm, P.C. The case was defended by Timothy Gearin, David Ott, and Scott Kozak of Armstrong Teasdale.

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