Student Death | Experts say health case unlikely to go to court

Though attorney Thomas Kline is investigating whether the Hospital of the University of Pennsylvania could have prevented the death of College sophomore Anne Ryan, legal experts say it is unlikely the case -if there is one- will go to court.

Ryan, 19, died on Sept. 9 of meningoccocal meningitis, three days after she visited HUP experiencing symptoms typical of the disease.

Kline is looking into Ryan's care, questioning whether HUP's treatment met appropriate medical standards and if technicians performed the correct laboratory tests. He refused further comment for this article.

In order to win a trial, Kline would have to prove that there was a misdiagnosis and that the attending physician showed a "deviation from the standard of care," said University of California Hastings College of Law professor Marsha Cohen.

"An overwhelming percentage of all personal injury lawsuits are settled" out of court, she said.

Alicia Ouellette - the director of the Health Law and Ethics Program at the New York-based Alden March Bioethics Institute, bioethics research institute based at the Albany Medical College - cited a lack of evidence for malpractice and a desire to avoid negative publicity as among possible reasons for choosing to settle.

Ryan was admitted to HUP on Sept. 6 complaining of a high fever, back and neck ache, nausea and difficulty walking.

According to Ryan's discharge record, which Kline provided to The Daily Pennsylvanian, she was diagnosed with a viral infection after her spinal tap came back negative - an indication that she did not have the meningococcal bacteria that causes meningitis - and was discharged with instructions to follow up with Student Health Service.

She was hospitalized again on the morning of Sept. 8 and died the next day.

Lawyers are also asking about the level of communication between HUP and Ryan in the days after her initial visit to the emergency room.

The University will not comment on the details regarding the course of Ryan's illness and medical treatment because of the Ryan family's request for privacy.

Law professors familiar with medical cases say Kline's allegation of misdiagnosis does not necessarily mean that the HUP physicians who treated Ryan did anything wrong.

"It is possible to make a misdiagnosis while acting responsibly," Ouellette said.

Klein's allegation of misdiagnosis is equivalent to an allegation of medical malpractice, legal experts say.

Meningococcal meningitis can be particularly difficult to diagnose because its early symptoms often resemble those of other, "more common and less serious illnesses," said Nancy Messonnier, chief of the meningitis branch of the Center for Disease Control. "It is not uncommon" for a spinal tap to come back negative in the early stages of the disease.

"There are some patients where it's amazingly obvious that they have the disease, but those patients are a rarity," she said.

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