Jury members began hearing evidence Tuesday in a medical malpractice lawsuit between Melinda and Kelly Williams and Dr. Jim Prescott, all of McPherson.
The Williams are suing Prescott because they believe he gave insufficient treatment to their 8-year-old daughter, Courtney, who died in September 2008 from a ruptured colon.
Prescott was the primary care physician for Courtney until May of 2006 and has cared for other members of the Williams family.
The prosecution said Prescott gave the wrong diagnosis of Courtney’s condition and didn’t do enough to treat her.
Prescott’s defense said Prescott’s diagnosis and treatment were correct and confirmed by two other doctors. His attorney said Courtney’s death was the result of failure to follow the prescribed treatment.
In 2004, Melinda Williams brought Courtney to Prescott's office twice because the child was experiencing bowel problems. Prescott took an x-ray of Courtney's bowel area and diagnosed her with functional constipation.
Prescott said functional constipation, or encopresis, is common among children. He said the condition occurs when fecal matter hardens in the colon, making it difficult and painful to defecate.
Prescott said this condition can take months or years to resolved.
Prescott prescribed laxatives. He said his office records of Courtney's later visits indicate that her condition improved, though Courtney still had intermittent bowel problems.
Prescott referred the family to Dr. Charles Hodge, a pediatric bowel specialist in Kansas City. Hodge confirmed Prescott's diagnosis and prescribed the same treatment.
However, Dr. Peter Dewitt, also of McPherson, said he did not agree with Prescott's methods. Dewitt met with Courtney in September 2008, 10 days before the child passed away.
Dewitt said when he reviewed the x-ray images Prescott took, he saw signs of possible megacolon, or an enlarged colon. He said Prescott should have been more diligent in his diagnosis and other methods of clearing Courtney's bowels should have been used.
Prescott said megacolon comes with functional constipation and that other methods of clearing Courtney's bowels would have been too traumatic for the child, who Prescott said was afraid of physicians.
Dewitt said gaining a child's confidence is crucial for a doctor.
“If you don't build a rapport with the child from the first visit, you're going to have problems,” Dewitt said.
Dewitt said during cross-examination that he first looked at the x-ray images Monday night.
In May 2006, the Williams stopped taking Courtney to see Prescott. At that time, Prescott recommended a strict laxative regimen, which Courtney's parents had interrupted during the school year because Courtney's difficulty controlling bowel movements at school had become embarrassing for the child.
Prescott said he was not told that the family would no longer see him.
In July, the Williams visited Hodge, who later spoke with Prescott over the phone. A nurse's note in Hodge's records indicated Prescott had agreed to contact the family by phone to follow up on Courtney's treatment.
The prosecution and Dewitt said Prescott's failure to follow through on that agreement constituted neglect. Prescott denied making this promise.
Prescott's defense said Courtney's condition worsened because she was not given laxatives as prescribed. He said although functional constipation is not considered a lethal condition, it can lead to other problems if not treated.
“Any problem can get worse,” Prescott said. “I can't make people do things they've decided not to do.”
The court adjourned during the defense's cross-examination of Dewitt. The trial was set to resume at 9 a.m. today.