Case Summary:

Plaintiff, age 16 at the time, presented to a local emergency room

complaining of intense right-sided testicular pain for the past two hours. At the ER, the primary diagnosis was noted to be testicular torsion by the NP attending. The urologist on call was contacted and refused to come to the ER and evaluate the plaintiff because of the fact that ultrasound was not available after 11:00 p.m. and suggested that the plaintiff be transferred to another hospital. This refusal was well documented by the emergency department at the time.

Plaintiff was then transferred to another hospital, which caused a significant delay in his treatment. Evaluation there revealed "+ right scrotal erythema and swelling, testicular lie feels transverse, testicle is tender to palpation, no right cremesteric reflex observed; left scrotal sac normal in appearance and non-tender." A testicular ultrasound was then performed. The ultrasound showed "diffuse diminished flow throughout right testis, highly suggestive of testicular torsion." A left-sided varicocele was also noted. The urologist on call was then consulted by telephone and exploratory surgery was planned. At the time of surgery, the right testicle could not be saved so a right orchiectomy and left orchidopexy were performed.

Plaintiff's counsel retained a board certified urologist who opined that the defendant urologist departed from standards of care expected of the average qualified urologist on November 8, 2013 when he refused to come to the hospital and examine and evaluate the plaintiff. He further opined, to a reasonable medical certainty, that had the defendant complied with standards of care expected of the average qualified urologist at the time and come to the hospital to evaluate the plaintiff, as he should have, he would have confirmed the presence of the testicular torsion suspected by the Emergency Department medical providers, and conducted an orchiopexy in a timely manner, which would have, more probably than not, saved the young man's right testis. This expert also opined that testicular torsion is a clinical diagnosis made by history and physical examination and that the average qualified urologist at the time should have been competent to diagnose the plaintiff's torsion by physical examination alone. He also opined that the average qualified urologist at the time would have been expected to know that testicular torsion is a true medical emergency with a finite amount of time for orchiopexy to take place: no more than 4-6 hours after onset of the torsion and that the defendant's refusal to evaluate the patient in a timely fashion increased the likelihood of right testicular loss.