Diagnostic Delays With Bacterial Meningitis

To the Editor.  —In their article, Dr Kallio and colleagues¹ note that failure to promptly diagnose meningitis accounts for most meningitis lawsuits, which are the leading malpractice suit against pediatricians. Their study found no difference in the outcome of children whose meningitis was diagnosed at once compared with those with a recent previous (2 to 4 days) visit to a physician. Although the final conclusion is not stated, the inference to be drawn is that the direct causality portion of a malpractice action cannot be established and, therefore, a malpractice verdict against a physician for a 2- to 4-day delay in the diagnosis of meningitis should not occur. However, the conclusion is not supported by the data presented.The power of their study does not allow the authors to accept the null hypothesis or to conclude that a relationship does not exist between a previous visit and adverse outcome.