Freshman's Family Will Sue UHS for Alleged Malpractice

The family of a Radcliffe freshman will file a malpractice suit within the month charging the University Health Services (UHS) and one of its doctors with failing to detect the student's appendicitis when she was taken to the UHS emergency room last December 17.

The student, Mary E. Munch '80, underwent emergency surgery for a burst appendix and peritonitis six days later at a hospital near her home in Denver. The Director of UHS yesterday disclaimed malpractice on its part.

The parents' law suit will also claim that subsequent serious complications resulted from UHS negligence, Christopher H. Munch, the student's father, said yesterday.

Munch, associate dean of the University of Denver Law School, alleges that when his daughter returned to the UHS February 27 the doctor who treated her then did not correctly diagnose her ulcerated colitis and refused to admit her to Stillman infirmary at UHS.

The next day private physicians hospitalized her at Massachusetts General Hospital for one week.

Dr. Warren E. C. Wacker, director of UHS, said yesterday that Munch's statements are "not inconsistent" with what he knows of the case from UHS records and the doctors involved, but added, "I feel very comfortable about our (legal) position."

Wacker did say that Munch was asked to wait for a surgeon to examine her during the February 27 UHS visit, but that she instead left after the first doctor examined her.

Munch said Tuesday that she left because of the pain she was experiencing and the doctor's alleged refusal to admit her to the infirmary.

'Callous'

Munch alleges that on both occasions the doctors were "very callous and not sympathetic at all." Other students with Munch reportedly agreed with this assessment.

In a January letter to Alberta Arthurs, acting dean of freshmen, the Munch family, and Wacker, Joseph D. Blair '74, senior advisor to freshmen, concluded that the doctor on duty December 17 was "remiss in his duties" and had "made a hasty diagnosis of her illness."

Blair based his criticism on reports on the incident from Munch's proctor, several students who accompanied her to the UHS emergency room, and the police officers who drove her there.

Dr. Wacker said his confidence in UHS's legal position stems from the fact that in its early stages, appendicitis is very difficult to differentiate from other less serious intestinal ailments. He said that therefore the doctor was not negligent in diagnosing the appendicitis as gastroentritis, or common stomach flu.

An independent physician familiar with such cases agreed yesterday that in its early stages, appendicitis is sometimes hard to diagnose because the pain is not yet localized in the lower abdomen.

Doctors Not Named

Dr. Wacker refused yesterday to name the doctors involved. UHS has been sued for malpractice in the past, he said, but he couldn't recall how often. He said that UHS's insurance company hires attorneys to defend malpractice suits.

According to the Blair letter, Mary Munch had been vomiting every few minutes and was unable to sit or walk without assistance when the University police took her to UHS at 1 a.m. December 17.

The doctor "heard her symptoms and took her temperature, and without any other tests diagnosed her illness as flu," Blair wrote.

The doctor then told her she was "lucky not to be vomiting as much" as other flu victims, gave her an anti-nausea injection which failed to improve her condition, and told her to rest at home, the letter states.

Munch's roommate called the UHS later that day to relate the incidents of the night before. A nurse then asked the roommate to bring Munch to the UHS for further examination, but Munch decided she was feeling too poorly to "go through that ordeal again."

She flew home the next day and had to be carried from the plane and taken to the emergency room of a Denver hospital, the letter continued.

Dr. Wacker cited the nurse's advice to return to UHS as further evidence that the University will, in his opinion, not be convicted of malpractice.

According to Munch's father, surgeons at St. Luke's Hospital in Denver emerged during the operation to inform the parents of the burst appendix and warn them "that there were great risks she would not survive the operation."

Munch said that in the opinion of his daughter's Denver doctors the appendix had probably burst during the morning following her initial UHS visit and that standard procedure in a case involving such severe abdominal cramps is to take a white blood cell count, which the UHS doctor failed to do.

Dr. Wacker yesterday said that treatment in such cases is "a question of judgment" and that he was "satisfied that what was done was quite reasonable."

He also maintains that UHS's most recent refusal to admit Munch to Stillman infirmary, when it was discovered later that she had ulcerated collitis, was reasonable because Munch voluntarily walked out of the emergency room after waiting briefly for an on-call surgeon the doctor had summoned.

Munch claims she left because she was refused admittance to the infirmary.

"If there's something physically wrong with them or if they just need a couple days away from the dorms we are generally very liberal in admitting students to the infirmary," Dr. Wacker said.

But he said the University was not at fault because, "If the surgeon came in and decided it was safe for her to go to Stillman the option was still open to her," he said.

Munch said yesterday that he has turned the case over to a private lawyer, and that it is still uncertain whether the suit will be filed in his daughter's name or in his name in his daughter's behalf