Case 13

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A 6-year-old boy with reactive airway disease missed his follow-up medical appointment with his primary healthcare provider after hospitalization for a severe acute asthma exacerbation. His asthma had been previously under control, but exposure to a new family cat resulted in severe respiratory distress and required admission to an intensive care unit. In addition to missing the follow-up appointment, his mother did not obtain a refill for his prescribed medication. Although the appointment was rescheduled, he began wheezing again before he was seen. This episode required an emergency department visit and re-admission to the hospital. A complete history was obtained.

Which of the following factors would lead to a suspicion of medical neglect?

A. The family lives in a rural area and transportation to the primary care office was not easily accessible.

B. The family was unable to find a home for their cat.

C. The mother was informed that missing the appointment and not filling the prescriptions would likely cause the child to become ill again.

D. The mother was ill at the time of the first appointment.