Joseph Farias, age 29, began treatment with the defendant internist, Yolanda Co, M.D., in February 2002. He came to the doctor with complaints of constipation for three years and rectal bleeding. Dr. Co performed a rectal exam and ordered a colonoscopy, which came back negative. There was no cause determined as to why Farias had rectal bleeding.
In October 2003, Farias returned to Dr. Co with new complaints of rectal bleeding. That visit was a cause of what became a medical malpractice lawsuit. This time Dr. Co did a digital rectal exam and diagnosed internal hemorrhoids. In Farias’s Cook County complaint, it was alleged that the internal hemorrhoids could not be diagnosed through digital examination unless the internal hemorrhoids were visualized outside the anus. The standard of care as contended required Dr. Co to perform an anoscopy to properly visualize the hemorrhoids. It was also asserted that should Dr. Co not have the facility to do the anoscopy, she should have referred Farias to another physician such as a gastroenterologist.
Dr. Co defended the case by saying that she did observe prolapsing internal hemorrhoids (protruding out of the rectum), even though her chart stated only internal hemorrhoids. Dr. Co testified that the standard of care required a treating internist such as herself to grade and chart the severity of an internal hemorrhoid, but she admittedly didn’t do that in October 2003.