Did on-call’s refusal to provide consult lead to loss of testicle?
Timely torsion diagnosis, orchidopexy could have saved testicle, medical expert argues
A 16-year-old Massachusetts boy presented to the hospital emergency room with complaints of intense right-sided testicular pain for over 2 hours. He was diagnosed with testicular torsion by an attending nurse practitioner.
The on-call urologist was informed of the diagnosis, but declined to come to the ER and consult with the patient because the ultrasound was not available after 11 p.m. The urologist suggested the boy be transferred to another hospital.
The teen was then transferred to a second hospital, where an evaluation revealed right scrotal erythema and swelling. The testicular lie felt transverse and tender to palpation. No right cremasteric reflex was observed, and the left scrotal sac appeared normal and non-tender.
A testicular ultrasound revealed diffuse diminished flow throughout the right testis, highly suggestive of testicular torsion. A left-side varicocele was also noted. The on-call urologist was consulted by phone and exploratory surgery was ordered. The patient underwent surgery, but the right testicle could not be saved. A right orchiectomy and a left orchidopexy were performed. A $750,000 settlement was reached.