Breast infection misdiagnosed

A SWOLLEN, TENDER AREA DEVELOPED on a mother’s right breast 3 weeks after giving birth. She called her ObGyn to report that pus was oozing from the nipple. He prescribed an antibiotic for what he presumed to be a clogged milk duct, and told her to continue to breastfeed. The infection worsened, until milk ceased to flow and the breast was red, painful, and warm.

At an office visit 2 weeks after the phone call, the ObGyn prescribed a new antibiotic, and told the mother to let the right breast milk dry up. Within 24 hours, pus breached the skin several centimeters above the nipple. The patient went to the emergency department, where 100 cc of pus was surgically removed. The infection was diagnosed as methicillin-resistant Staphylococcus aureus (MRSA). The patient was found to also have a MRSA infection in her left breast, but that infection was able to be treated by needle drainage. The ObGyn reported that he believed that the MRSA infection had developed shortly after the office visit.

PATIENT’S CLAIM The ObGyn was negligent in not diagnosing the infection earlier. MRSA infection could not have developed as quickly as the physician said; it probably started when pus began oozing from the nipple 3 weeks after childbirth.

PHYSICIAN’S DEFENSE The initial infection was in a clogged milk duct. Staphylococcal infection is rare in nursing mothers.

VERDICT A $200,000 Missouri verdict was returned.