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EMERGENCY MEDICINE: Failure to Properly Evaluate and Refer to Urologist Following Blunt Trauma to Te

We thank Charles E. Rawlings, attorney for the plaintiff, for sending us a report of this case. The plaintiff went to the emergency room at Cherokee Indian Hospital in Cherokee, North Carolina with acute pain caused by testicular trauma after being hit by a softball. The plaintiff was also urinating blood. The plaintiff was evaluated by family nurse practitioner Michael B. Wiseman, who prescribed hydrocodone and naproxen. The plaintiff was discharged three hours later with advice to keep ice on the injury and to schedule an elective ultrasound in two days. The plaintiff had increasing pain and his right testicle continued to swell and he returned to the emergency department for re-evaluation. The emergency room physician immediately obtained a testicular ultrasound after an examination which revealed significant bruising, swelling and tenderness. The ultrasound revealed heterogeneous echo texture of the right testicle and fluid adjacent to the right testicle representing a moderate to severe contusion and adjacent hemorrhage or hydrocele. There was also questionable to absent arterial flow to the right testicle. The emergency room physician recommended that the plaintiff be seen by a urologist for an urgent evaluation, The urologist admitted the plaintiff for an immediate scrotal exploration. The urologist concluded that the right testicle was ruptured and the testicle was not viable, leading to it being removed. The urologist's operative report included comments that he might have been able to save the testicle if he had seen him on the day of the accident. The plaintiff alleged negligence in the failure to order and review a testicular ultrasound before his discharge at the initial presentation. The plaintiff also claimed that Wiseman should have referred him for a urology consult for the same day. The defendant argued that the testicle might not have been salvageable even with earlier surgery. A $100,000 settlement was reached prior to filing a formal claim, Plaintiff's Expert: Denise Coppa, R.N.P., adolescent and pediatric medicine nurse practitioner, North Kingstown, RL Anonymous Man v. Anonymous Nurse Practitioner, unknown North Carolina venue. Charles E. Rawlings, Winston-Salem, NC for the plaintiff.

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