Acute Appendicitis and Risks For Misdiagnosis and Medical Malpractice

Find out the reasons for and causes of misdiagnosis of appendicitis and how it might present a medical malpractice case and what you can do about it.

The appendix is a small tubular organ attached to the colon. It is located in the lower right quadrant of the abdomen. A blockage within the appendix can be caused by feces, inflammation of intestinal lymph nodes or parasites. An infection of this organ, that serves no function, is potentially life threatening, especially if misdiagnosis occurs.

Patients with abdominal pain make up 5 to 10 percent of emergency room visits. Of those, only a small number will have appendicitis.

Approximately 1.1 in 1,000 people in the US, or 7 percent of the population, will develop appendicitis. The frequency of appendicitis climbs from birth, climaxes at approximately 18 or 19 years and slowly decreases thereafter. Men are almost one and a half times more likely to develop appendicitis than women.

Appendicitis has a high risk for misdiagnosis. There are no conclusive tests for detection of appendicitis. However, there are some procedures which ought to be followed. The physician should apply pressure to the abdomen to check muscle responses and rebound tenderness. A pelvic and/or rectal examination may also be performed. Blood tests are carried out to check for elevated white blood cell counts which may indicate infection. For cases where physical examination and lab tests are inconclusive, CT scans or ultrasound may be utilized.

Symptoms of appendicitis are:

  • Rapid onset and worsening of abdominal pain
  • Appetite loss
  • Nausea or vomiting
  • Constipation or diarrhea
  • Fever
  • Abdominal swelling

Not all patients exhibit these symptoms which leaves open the possibility of misdiagnosis resulting in doctor malpractice.

Another situation that increases the failure to properly diagnose risk is appendicitis can mimic other medical conditions such as:

  • Intestinal obstruction
  • Inflammatory Bowel Syndrome
  • Gynecological disorders
  • Intestinal adhesions
  • Constipation

Appendicitis is treated by surgical removal of the appendix by either a traditional incision or a laparoscopic procedure.Due to their less invasive nature, Laparatomies generally have less complications and a faster healing rate. If left untreated, the appendix can rupture spilling toxic substances into the abdominal cavity. A perforated appendix increases the morbidity risk substantially.

The mortality rate for appendicitis is 0.2 to 0.8 percent. For patients older than 70, it rises to 20 percent. The perforation rate is higher in people younger than 18 years or older than 50. The mortality and perforation rates may be higher in the last two circumstances due to diagnostic delay.

There are three types of medical misdiagnosis. An improper diagnosis is a diagnosis given based on symptoms that may be similar to another condition. Another kind of misdiagnosis is when a secondary underlying condition is not detected and treated appropriated. The third form is delayed diagnosis where the medical condition is initially overlooked and diagnosis is not made until the condition has worsened.

Misdiagnosis of appendicitis is in the top five medical malpractice categories for lawsuits against emergency room doctors.