Mario Guzman, San Jose

On January 5th, 2013 Mario Guzman went running with his wife in the hills near their house. Despite some nasal congestion and weakness for the past few weeks, he ran, thinking exercising might make him feel better. During his run, he twisted his ankle. But even with the pain, he completed his jog.

During the weekend, he was able to continue all his normal activities, however, on Monday, January 7th, his ankle suddenly got swollen and red. It started to hurt so much he could not put any weight on it. He also developed a fever of 100F.

His condition did not improve, so Guzman and his wife made an appointment to see a doctor on January 8th. His hurried doctor did a bare-bones examination that lasted about 10 minutes and quickly diagnosed him as having the flu and a sprained ankle. The results of the x-ray were negative for a sprain and his clinical presentation at that point was consistent with either a joint or soft tissue infection. It was below the standard of care to diagnose him with flu as his nasal congestion was an old symptom which did not worsen as would be expected when infected with influenza.

After following the advice of the doctor for several days, Mario's condition did not improve. He consistently updated Kaiser Permanente about his worsening condition but was told to stay home and wait for the flu to subside, without offering something as simple as a $30 blood test to rule out the possibility of sepsis.

The advice that was given to Mario delayed his arrival to the hospital between 10-24 hours. The staff downplayed his symptoms and suggested that he go to the ER only if he reported a pain level of 10 out of 10. By the time he arrived at the emergency room, he was septic and in toxic shock, both outcomes caused by streptococcus pyogenes -- a common bacteria easily treated with antibiotics.

He then spent 4.5 months hospitalized. As a consequence of both the infection and his life-saving treatment, Mario lost portions of each of his limbs. More importantly, he is paralyzed due to severe nerve damage caused by sepsis, an outcome that could have been avoided had his doctor run $30 worth of tests and medications.

During the ordeal, Guzman and his wife made multiple requests for Kaiser to improve their protocols for diagnosing sepsis, all of which were ignored. In spite of the fall out, the doctors who were responsible are still on the payroll and continue to practice at the clinic, all without any disciplinary action.

In the end, they filed a lawsuit which went to private arbitration. Because of the 45-year-old cap on compensation for patients injured as a result of medical negligence, the arbitrator ruled that even though the doctor didn’t act within the standard of care, Guzman was only entitled to $250,000.