Arthritis & Rheumatology Center complaint alleges rheumatologist advised a dentist for jaw pain before vision loss

The complaint alleges that a rheumatologist treated a patient for polymyalgia rheumatica for almost four months without warning her about giant cell arteritis. The patient later reported excruciating jaw pain and difficulty chewing through the practice’s online portal. The rheumatologist replied that her steroid dose may need to stay at 4 milligrams and to see a dentist. She was not told to seek an urgent medical evaluation for the jaw symptoms. Days later she lost vision in her right eye and was diagnosed with giant cell arteritis.

System: Arthritis & Rheumatology Center, P.C.
Facility: Arthritis & Rheumatology Center, P.C.
Providers involved: Serene A. Francis, M.D. / Arthritis & Rheumatology Center, P.C.
Pattern: Alleged failure to warn of giant cell arteritis symptoms and direct urgent care for jaw pain in a polymyalgia rheumatica patient
Harm: Alleged giant cell arteritis and severe vision loss in one eye

Overview

This page concerns a public complaint alleging a rheumatologist did not warn a patient about giant cell arteritis before she lost vision in one eye.

Chronology

The complaint alleges as follows:

The patient saw the rheumatologist on May 2, 2022 for joint pain and started prednisone after a diagnosis of likely polymyalgia rheumatica.
A physician assistant saw the patient on August 2, 2022, and the visit notes conflicted on whether she had jaw pain or jaw tenderness.
On August 26, 2022, the patient messaged the practice that her jaw pain was excruciating and she was having trouble chewing and eating.
The rheumatologist responded the same day that the steroid dose may need to stay at 4 milligrams and told her to see a dentist.
On September 3, 2022, the patient told the rheumatologist she had lost vision in her right eye overnight.
A retina specialist examined her on September 4, 2022, diagnosed a retinal artery occlusion, and referred her for emergency evaluation.
Emergency-department physicians admitted her for high-dose steroids. On September 26, 2022, her vision in that eye measured ’count fingers at six feet.’

Alleged failures

The complaint alleges the following failures:

The rheumatologist did not educate the patient about possible giant cell arteritis with polymyalgia rheumatica, including warning signs such as jaw claudication.
The rheumatologist did not document any such warning in the patient’s medical records.
The filing alleges the standard of care required an urgent medical evaluation, not a dentist referral, after she reported excruciating jaw pain and difficulty eating.
The complaint pleads medical malpractice and vicarious liability against the defendants, and attaches an expert affidavit under O.C.G.A. § 9-11-9.1.

Entities and tags

Arthritis & Rheumatology Center, P.C.Serene A. Francis, M.D.Giant cell arteritisPolymyalgia rheumaticaCentral retinal artery occlusionJaw claudicationFulton CountyDelayed or missed diagnosisInformed consentRheumatologyOphthalmologyEmergency medicine