Blood Lies - Medical Puzzles

FRESNO, Calif.

Before Dr. House, there was Dr. Michael Laposata! For 15 years, he's been figuring out what's wrong with patients when other doctors can't.

"We take tests that are very complicated and very difficult to interpret and that people have learned very little in medical school, and we force them to pick between thousands of different tests and interpret the results correctly," Michael Laposata, M.D., a clinical pathologist at Vanderbilt University, told Ivanhoe. "It turns out, 50 percent of the cases require some sort of change, which is dramatic."

Today, Dr. Laposata's patient is a 54-year-old woman diagnosed with pulmonary hypertension. His team at Vanderbilt is the first in the country to bring physicians, clinical pathologists, and lab experts together to break down blood disorders. They review tests that have been ordered, the tests that haven't, and the tests that need to be ordered. It's all done on-the-spot while patients are being treated.

Not long ago, Dr. Laposata's patient was a little boy named Craig. The 3-year-old had fallen off his bed.

"I heard somebody fall, so I sprinted upstairs. When I went into the bedroom, Craig was laying on the floor," Steven Smith, Craig's father, told Ivanhoe. "I remember holding him in my arms and [saying], 'Craig, Craig, Craig.' He didn't respond. He was limp."

Craig was rushed to the hospital. After emergency brain surgery, doctors and nurses immediately blamed… his father! "We get pulled into a conference room by one of the doctors, and she says, 'We've run tests. We've eliminated all other possibilities.' I'm looking at child abuse," Corinne Smith, Craig's mother, told Ivanhoe.

Craig's brain and eye bleeding looked just like shaken baby syndrome. Steve Smith was charged with child abuse and attempted murder. The courts ordered him to keep away from all three of his children.

"This unbelievable odyssey began for us," Steven told Ivanhoe.

A new type of medical team -- experts trained to know which test to order and when -- could change the lives of millions of others.

"Nobody believed it was possible to have that much bleeding with a minor fall," Dr. Laposata told Ivanhoe.

Dr. Laposata believes up to one in every 100 child abuse cases could be misdiagnosed.

"75 percent of doctors told us if we wouldn't have given them the interpretation, they would have made a mistake," Dr. Laposata said.

After spending $75,000 in legal fees, Steve found Dr. Laposata. His tests on Craig didn't reveal shaken baby syndrome but rather a blood disorder called von Willebrand disease.

The Smiths say they divorced in 2009 in part due to the stress of those false accusations. Sadly, they have no legal recourse, as most child abuse reporting laws protect hospitals and doctors from misdiagnosis. That's why they support creating more teams like these, which are crucial for doctors and patients alike.

Craig Boerner/Media Relations
Vanderbilt University

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