Daniel E. Holloway
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Wellstar Medical Group complaint alleges repeated gout misdiagnosis before a diabetic patient’s necrotizing fasciitis

The complaint alleges that urgent-care and family-medicine physicians repeatedly diagnosed gout in a diabetic patient’s worsening foot infection. On January 26 and 29, 2020, a physician treated the patient’s swollen, reddened toe without ordering imaging or lab work beyond a glucose check. A second physician examined the toe on February 4, 2020, and ordered an X-ray and a uric acid level. Though he told the patient the uric acid level was normal, he diagnosed a gout flare. A podiatrist who examined the toe two days later sent the patient directly to an emergency department for a suspected infection. During surgery the next day, a podiatrist found dead and infected tissue consistent with necrotizing fasciitis. The patient underwent multiple debridement surgeries, amputation of the great toe, and a skin graft.

System
Wellstar Medical Group, LLC
Facility
WMG Urgent Care and WMG Family Medicine at East Cobb Health Park
Providers involved
Wellstar Medical Group, LLC / Pelham Williams, MD / Lloyd D. Weddington, MD
Pattern
Alleged repeated misdiagnosis of gout in a diabetic patient with a worsening foot infection, mostly without imaging or lab testing
Harm
Alleged necrotizing fasciitis requiring amputation of the great toe and skin grafting

Overview

This page concerns a public complaint alleging that urgent-care and family-medicine physicians repeatedly misdiagnosed a diabetic patient’s foot infection as gout.

Chronology

The complaint alleges as follows:

  1. The patient has diabetes and had been treated for staph infections at the same clinic in November 2019 and January 2020.
  2. On January 26, 2020, a physician diagnosed the patient’s swollen, painful toe as gout without ordering imaging or labs, and gave a steroid injection.
  3. On January 29, 2020, the patient returned with increasing redness, warmth, and pain, and an elevated glucose reading, and the physician again diagnosed gout.
  4. On February 4, 2020, a second physician examined the toe, ordered an X-ray and a uric acid test, and diagnosed a gout flare.
  5. On February 6, 2020, a podiatrist examined the toe and sent the patient directly to an emergency department for a suspected infection.
  6. He was diagnosed with an infection, started on intravenous antibiotics, and underwent surgical debridement the next day, which revealed findings consistent with necrotizing fasciitis.
  7. He later underwent additional surgeries, including amputation of the great toe and a skin graft.

Alleged failures

The complaint alleges the following failures:

  • The urgent-care physician did not order imaging or laboratory testing before diagnosing gout in a diabetic patient with a swollen, painful foot.
  • He diagnosed gout again despite worsening redness, warmth, and pain and an elevated glucose level.
  • The family-medicine physician diagnosed a gout flare despite a red, swollen toe and a uric acid level he described as normal.
  • Wellstar Medical Group, LLC is vicariously liable for both physicians’ acts under respondeat superior and apparent agency, the complaint alleges.
  • The complaint pleads medical malpractice and negligence against the physicians and Wellstar Medical Group, LLC, with an expert physician’s affidavit under O.C.G.A. § 9-11-9.1.

Entities and tags

Wellstar Medical Group, LLCPelham Williams, MDLloyd D. Weddington, MDGout misdiagnosisDiabetes mellitusNecrotizing fasciitisToe amputationCobb CountyDelayed or missed diagnosisInfectionUrgent careFamily medicinePodiatryInfectious disease