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Case Reports in Pediatrics
Volume 2017, Article ID 5163094, 3 pages
Case Report

Keeping an Open Mind: Cognitive Bias in the Evaluation of an Infant with Posterior-Lateral Rib Fractures

1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
2Department of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN, USA

Correspondence should be addressed to Jason Homme; ude.oyam@nosaj.emmoh

Received 19 July 2017; Revised 22 September 2017; Accepted 2 October 2017; Published 26 October 2017

Academic Editor: Georg Singer

Copyright © 2017 Katie Johnson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A four-month-old former premature male is incidentally found to have posterior-lateral rib fractures during evaluation of a febrile illness. This finding led to the initiation of a workup for nonaccidental trauma. A thorough history and physical exam ultimately led to the diagnosis, which was not related to abuse. This case highlights a rare sequela of patent ductus arteriosus repair, cautions medical teams to remain aware of how cognitive bias can affect diagnostic decision-making, and emphasizes the importance of a thorough history, physical exam, and medical record review in cases of suspected nonaccidental trauma.