Daniel E. Holloway
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St. Joseph’s/Candler Urgent Care complaint alleges hemorrhoid diagnosis without rectal exam before Fournier’s gangrene

The second amended complaint alleges that a patient who presented to a St. Joseph’s Candler Urgent Care in Savannah with a week of painful hemorrhoids and swelling was seen by a nurse practitioner who recorded a pulse of 114 and a blood pressure of 139/101 mmHg, did not perform a genitourinary or rectal examination, diagnosed uncomplicated hemorrhoids, and prescribed a laxative and prednisone. The record states that the patient refused a rectal examination, but he was never offered one. Eight days later he was diagnosed with Fournier’s gangrene, was hospitalized in critical condition with septic shock, and required six surgeries over six weeks.

System
St. Joseph’s/Candler Urgent Care Centers
Facility
St. Joseph’s Candler Urgent Care
Providers involved
St. Joseph’s/Candler Urgent Care Centers, LLC / Marquez Reid, NP / Reginald Davis, Jr., M.D. / Premier Health Consultants, LLC
Pattern
Alleged urgent-care diagnosis of uncomplicated hemorrhoids without a rectal examination despite an elevated heart rate
Harm
Alleged Fournier’s gangrene, septic shock, six weeks of hospitalization, and six surgeries

Overview

This page concerns a public second amended complaint alleging that an urgent-care nurse practitioner and his supervising physician diagnosed uncomplicated hemorrhoids without a rectal examination before the patient was diagnosed with Fournier’s gangrene.

Chronology

The complaint alleges as follows:

  1. The patient presented to St. Joseph’s Candler Urgent Care in Savannah on September 22, 2024 with a week of painful hemorrhoids, constipation, and swelling.
  2. Marquez Reid, NP documented a general examination with normal findings, did not perform a genitourinary or rectal examination, diagnosed “uncomplicated, unspecified hemorrhoids,” and prescribed a laxative and prednisone.
  3. The medical record states the patient refused a rectal examination, but he was never offered one and did not refuse it.
  4. The patient presented to an emergency department on September 30, 2024, eight days later, with persistent rectal pain and diarrhea and was diagnosed with Fournier’s gangrene.
  5. He was taken emergently to the operating room for debridement and hospitalized in critical condition with septic shock, remaining hospitalized for six weeks and undergoing six surgeries.

Alleged failures

The complaint alleges the following failures:

  • Marquez Reid, NP failed to repeat an elevated heart rate of 114 and, if still elevated, to diagnose and treat its cause.
  • The complaint alleges that he failed to perform a genitourinary or rectal examination or to document any discussion of the risks of not performing it, and prescribing prednisone for uncomplicated hemorrhoids fell below the standard of care.
  • Reginald Davis, Jr., M.D., as supervising physician, oversaw, managed, and signed off on the nurse practitioner’s care.
  • The complaint alleges that St. Joseph’s/Candler Urgent Care Centers, LLC and Premier Health Consultants, LLC are vicariously liable for the acts of the nurse practitioner and the supervising physician.
  • The complaint states that an expert affidavit under O.C.G.A. § 9-11-9.1 is attached.

Entities and tags

St. Joseph’s/Candler Urgent Care Centers, LLCMarquez Reid, NPReginald Davis, Jr., M.D.Premier Health Consultants, LLCFournier’s gangreneHemorrhoidsRectal examinationPrednisoneSeptic shockDebridementChatham CountySavannah, GeorgiaDelayed or missed diagnosisSepsisUrgent careEmergency medicine