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case study:  Patient: M.T., 44-year-old warehouse... | Nursing

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Patient: M.T., 44-year-old warehouse supervisor  Chief concern (Day 1): “Bad low-back pain after lifting a box.”  Home AI tool: Patient uses the health system’s portal symptom-checker chatbot. After entering “low back pain,”  “both legs tingling,” “can’t feel when wiping,” and “peeing less than usual,” the bot outputs “likely muscular  strain home care; clinic visit in 3–5 days.” No red-flag alert is displayed.  Course:  • Day 2–3: Pain worsens; bilateral sciatica, saddle numbness, and urinary retention (“I haven’t peed since  last night unless I strain”). The bot again recommends home care.  • Day 4 (ED): Patient febrile, hypotensive, confused. Bladder scan >1200 mL; purulent urine after  catheterization. MRI lumbar: massive central L4–L5 disc herniation compressing cauda equina.  • Labs: Leukocytosis, lactate 5.2 mmol/L, creatinine bump.  • Outcome: Despite urgent decompression and broad-spectrum antibiotics/ICU care, the patient develops  uroseptic shock with multi-organ failure and dies on Day 6.  Studies show online/AI symptom-checkers vary widely in diagnostic/triage accuracy and may miss  emergencies; WHO and AHRQ urge caution and human oversight for clinical AI
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