Saturday, December 15, 2012

Woman Misdiagnosed with Dementia Dies When She Could Have Lived



Mary Kruger was misdiagnosed with dementia. She died from a brain tumor that was operable , Mary Kruger's death could have been prevented had the appropriate tests for dementia been administered.


By Bob DeMarco
Alzheimer's Reading Room
 

Woman Misdiagnosed with Dementia Dies When She Could Have Lived
Mary Patricia Kruger was diagnosed with dementia and sent to a nursing home. A CT Scan a year and a half later, and the day before she died, revealed that she was wrongly diagnosed with dementia and instead suffered from a tumor that could have been treated.

The Coroner after a post-mortem examination ruled "Ms Kruger's death was prventable".  In addition, the Coroner ruled that there were at least 4 missed opportunities where Ms Kruger could have been correctly diagnosed.

This once again brings up an issue that I have written and spoken about passionately for years -

Is it really Alzheimers dementia or something else?


There are a long list of symptoms that can present as dementia. These include problems with:
memory, thinking, language, judgment, behavior, and a person’s ability to perform normal daily activities.
Dementia is a word that describes symptoms of the gradual deterioration of mental functioning that cannot be explained by normal aging.

In order to arrive at a diagnosis of probable Alzheimer's a long list of illnesses must first beruled out. In other words, a number of illnesses can present as "false positives" for Alzheimer's or a related dementia.

These false positives can only be ruled out through a series of appropriate tests.

A short list of illnesses that can present with Alzheimer's or dementia like symptoms include:
  • Metabolic and endocrine abnormalities -  too much or too little thyroid hormone or cortisol are examples;
  • Brain Lesions (tumors, collections of blood called subdural hematomas, and abscesses);
  • Infection (meningitis, encephalitis, syphilis, to name a few);
  • Impaired cerebral spinal fluid flow causing normal pressure hydrocephalus;
  • Radiation to the brain, or brain trauma;
  • Stroke;
  • and medication side-effects.
Severe depression can also cause dementia like symptoms. 

This is explains why medical, neurological, and psychiatric assessments are essential parts of the initial evaluation of dementia.

How many people worldwide are being misdiagnosed like Mary Kruger? How many doctors are failing to perform an appropriate brain scan before diagnosing dementia?

Did your loved one have all the appropriate tests including a brain scan before a diagnosis of Alzheimer's or dementia was rendered?

What if it isn't Alzheimer's?

The Coroner in Mary Kruger's case found:
...that Ms Kruger’s death was preventable. If the wrong diagnostic label had not been applied at Murray Bridge Hospital, it is likely that the meningioma would have been detected and treated. Ms Kruger may never have needed admission to a nursing home at that time, or not until later in her life. Secondly, had Dr Pye obtained appropriate information for the purposes of his referral to Dr McGovern, the meningioma may have been detected and properly treated. Thirdly, had Dr McGovern’s rooms not misfiled Ms Kruger’s notes, a proper report from Dr McGovern would have led to further investigations so that the meningioma may have been detected and properly treated. Fourthly, had Dr Pye, after prompting from the Philip Kennedy Centre and of his own initiative, followed up the lack of response from Dr McGovern, the meningioma may have been detected and properly treated.

Had the meningioma been detected and treated in early 2007, it is likely that Ms Kruger’s quality of life would have been improved. Her death would probably have been prevented.

Read the Coroner's Report
Original content Bob DeMarco, the Alzheimer's Reading Room

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