A 54 year old male patient, with a prior history of diabetes mellitus, hypertension and gout, fell on the job injuring the area surrounding his right hip. Despite using anti-inflammatory medication the pain became severe enough to be transported by stretcher to the emergency room. The nursing assessment indicated patient "had too much pain to walk. Pain '8' [on a scale of 1 to 10]." Patient received a significant amount of IV and IM medication for pain control prior to discharge from the emergency room. Because x-rays of the hip, pelvic, and lumbar spine showed no fracture or dislocation, patient was discharged with a diagnosis of "acute lumbo-sacral strain" with prescriptions for Vicodin and Flexeril. Though the patient maintained bed rest as advised, the pain worsened progressively over the next four days. Patient was then brought to an outpatient clinic and evaluated by a first-year medical resident who noted that he was "unable to lay down flat," "had difficulty moving around at home," and "was difficult to help up on the table." Resident reviewed patient's x-rays finding no fracture or bony abnormality and diagnosing his condition as muscle sprain. Patient was advised to continue Flexeril, Vicodin, and Ibuprofen, referred to physical therapy, and told to return in one month.

The resident discussed the case with the attending physician who did not question or examine the patient. 48 hours later, the patient was brought back to the ER with complaints of shortness of breath, weakness, right hip pain, diaphoresis and pallor. While in the ER, patient was hypotensive and exhibited respiratory distress. He developed septic shock and required intubation. Staph aureus was isolated from blood, urine and sputum. An abdominal CT scan was performed and displayed a psoas abscess with possible epidural extension. Attempted percutaneous draining yielded only a minor amount of hemorrhagic fluid but which also grew staph aureus.

Despite the appropriate antibiotic therapy, patient developed multiple complications including renal failure, rhabdomyolysis, and refractory shock requiring levophed and dopamine, and remained unresponsive. Though transferred for further treatment, patient subsequently expired.

medQuest provided a New York-based infectious disease expert for plaintiff's attorney who concluded that: "As a direct result of [the attending physicican's and the resident's] negligence, the psoas abscess remained undiagnosed and progressed. Complications include staphylococcal bacteremia, septic shock, multi-organ failure and death. Within a reasonable degree of medical certainty, had a CT scan or MRI been obtained before the patient developed septic shock, the fluid collection in the psoas muscle would have been easily visualized. A drainage procedure, Gram stain and culture could have been done promptly, and high dose intravenous antibiotics begun prior to the development of septic shock, thereby preventing the patient's death." A jury awarded the plaintiffs an $8 million verdict.