Medical Malpractice

Doctors Mistake Appendicitis for Fibroids and Menstrual Cramps Causing Serious Injury

May 21, 2023
surgeon performing surgery

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We recently settled a medical malpractice case for a substantial settlement that involved a failure to timely treat and diagnose appendicitis.

The case involved a young woman, only 24 years old at the time, who presented to the emergency room of a New York City hospital on four separate occasions between October 27, 2019 and March 17, 2020. She was experiencing symptoms consistent with acute appendicitis, including worsening pelvic pain, sharp pain on the right side of the abdomen, nausea, vomiting, and a distended stomach. Unfortunately, she was repeatedly misdiagnosed, and told that her pain was related to fibroids and menstrual cramps.

The defendant had taken the position that appendicitis and fibroids can have similar symptoms, particularly when it comes to pelvic pain, which is why it was appropriate to say the pain was related to fibroids. Defendant claimed that, in women, the pain from appendicitis can be felt in the lower right side of the abdomen, which is also the location of the appendix; and that fibroids can also cause pelvic pain, as well as heavy or prolonged menstrual bleeding, bloating, and other symptoms.

Although it can be difficult to differentiate between the two conditions, our experts were able to articulate that it was a departure from the standard of care to dismiss our client’s signs and symptoms as fibroids without proper diagnostic testing and a surgical consult. In this case, despite our client’s persistence, and her mother's insistence that something was not right, the woman's condition continued to worsen. She also had a documented appendicolith during an imaging study of her stomach, which is a known complication to increase the risk of appendicitis. Our client eventually flew back to California to be with her family, where she was taken to a hospital and properly diagnosed. It was discovered that she had a 10cm significant tubo-ovarian abscess, acute appendicitis, appendiceal endometriosis, sepsis, and peritonitis. As a result of the misdiagnosis, she underwent an extensive appendectomy and salpingectomy, the removal of her right fallopian tube.

This is an important case that highlights the critical need for timely and accurate medical diagnosis, and we hope it will serve as a reminder to all of us to remain vigilant about our health.

Delayed Appendicitis Diagnosis and Medical Malpractice


Medical Malpractice
Image of Appendix in Stomach

Physiologically, a blockage in the lining of the appendix that results in infection is the likely cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture. A rupture spreads infection throughout a patient’s abdomen (peritonitis). Possibly life-threatening, this condition requires immediate surgery to remove the appendix and clean the abdominal cavity. If a patient’s appendix bursts, they may develop a pocket of infection (abscess).

Appendicitis Diagnosis
Image of Acute Appendicitis

An abscess is a pocket of pus that forms due to an infection, typically caused by bacteria. The body's natural immune response to an infection is to send white blood cells to the affected area to fight off the invading bacteria. As a result, pus can accumulate, causing the abscess to grow in size. Appendicitis that is treated immediately is minimally invasive and will not spread to the peritoneal space or uterus area, which is what happened to our client. Our expert was able to demonstrate that the fact that our client had developed a substantial abscess was an indication that the appendicitis had been there for many months, including during the initial emergency room presentation.

This case is a prime example of how medical malpractice can occur when medical professionals fail to diagnose and treat conditions in a timely manner. Our client suffered greatly as a result of the delayed diagnosis and treatment; she developed worsened appendicitis, ruptured appendix, perforated appendicitis, large right tubo-ovarian abscess with pelvic involvement, peritonitis, septic shock, sepsis, 10 cm right pelvic abscess, significant bowl adhesions, left hydrosalpinx, need for IV, need for blood transfusions, dilated loops of bowel, bowel obstruction secondary to pelvic abscess and surrounding edema, laparotomy with appendectomy, abscess drainage and debridement, right salpingectomy. She also has significant abdominal adhesions that puts her at risk in the future of a complete or partial intestinal obstruction, also called small bowel obstruction. She has significant anxiety and is deeply afraid of visiting new doctors.

Our attorneys fought tirelessly to secure her the compensation she deserved during mediation. It is so important for medical professionals to conduct a thorough examination and diagnostic workup when a patient presents with symptoms of pain in the lower right abdomen. Failure to do so can result in a delayed or missed diagnosis, which can have serious consequences for the patient's health and well-being.

If you or a loved one has experienced a similar situation, we encourage you to reach out to us for assistance. We are here to help you pursue justice and ensure that medical professionals are held accountable for their actions.