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Failure to Diagnose Worsening Kidney Function

May/June 2019

Lacey Povrzenich, then 4, underwent blood work at Monongahela Valley Hospital, which reported that her creatinine value was normal. For the next seven years, she experienced recurrent urinary tract infections, for which pediatrician Dawn McCracken prescribed antibiotics. The doctor also ran repeat lab work.

Povrzenich was later admitted to the hospital, suffering from dehydration and vomiting. Testing showed an abnormally high creatinine level. A CT scan of her pelvis and abdomen showed abnormalities in her ureters and kidneys; however, this was not noted by the interpreting radiologist.

A year later, a physician’s assistant at a new health clinic, Mon Valley Community Health Services, noted that Povrzenich had high blood pressure. A second blood pressure reading that year was even higher. The following year, Povrzenich was rushed to a children’s hospital, where she was diagnosed as having end-stage renal failure, necessitating a double kidney transplant. She requires up to 30 pills daily for her condition.

Povrzenich sued McCracken, alleging that she had failed to properly interpret the first creatinine test, which was reported as normal using an adult reference range, and should have discontinued her antibiotic treatment. The plaintiff also alleged that the physician supervising the physician’s assistant at Mon Valley Community Health Services failed to review Povrzenich’s treatment plan and that the physician’s assistant failed to follow up on the high blood pressure readings.

The jury awarded the plaintiff $4 million, apportioning liability at 85 percent to McCracken and 15 percent to Mon Valley Community Health Services.

Citation: Povrzenich v. McCracken, No. 2015-4727 (Pa. Ct. Com. Pl. Washington Cnty. Oct. 15, 2018).

Plaintiff counsel: Douglas Price, Pittsburgh.

Plaintiff expert: Tej Mattoo, pediatric nephrology, Detroit.

Defense expert: Randall Jenkins, pediatric nephrology, Portland, Ore.