Failure to Diagnose

The No. 1 catalyst for medical malpractice claims is a physician’s failure, error or delay in diagnosis. Although no doctor is expected to get it right 100 percent of the time, they and other health care providers have a duty to offer care of reasonable quality.

The standard of care for diagnostics is determined by what other reasonably competent professionals with the same education, in the same medical field and under similar circumstances would have done.

As the Fort Lauderdale medical malpractice lawyers at The Ansara Law Firm can explain, a failure to diagnose a patient accurately is not in and of itself proof of negligence. The fact is that even skilled doctors make mistakes even when they are using reasonable care. It’s critical to ascertain whether the physician acted competently. That involves a meticulous evaluation of what the doctor, hospital and other health care providers did or did not do in arriving at – or missing – the diagnosis.

What’s more, a valid claim does not rest solely on whether the doctor or health care professional made a mistake, but also how the patient was affected by that mistake. In a lot of cases, a missed or delayed diagnosis is harmless. But when a patient suffers a worsened condition or even death as a result of the error or oversight, legal action may be appropriate.

A Harvard Medical Practice Study revealed that diagnostic error accounted for 17 percent of all preventable errors in hospitalized patients. Another systematic review of literature from 1966 to 2002 published in the Journal of the American Medical Association showed approximately 9 percent of patients in autopsies experienced a major diagnostic error that wasn’t detected while the patient was alive.

Researchers with the Agency for Healthcare Research and Quality (a division of the U.S. Department of Health and Human Services) opine there are a few different reasons for this. They may include:

• Cognitive bias by physicians. Doctors often use a method called “heuristics” to reach a conclusion on a provisional diagnosis, especially when a patient has certain common symptoms. Although these can be useful, they are also prone to error. For example, may employ “availability heuristic” by diagnosing a current patient based on experience with past cases. The problem is the doctors may overlook certain elements of the current case that are unique, as our Fort Lauderdale lawyers understand. Also common is the “anchoring heuristic,” which involves relying on an initial impression, even when subsequent information points to another conclusion.
• Poor teamwork and communication by clinicians. Lack of communication between primary care doctors, emergency doctors, surgeons and other health care professionals can result in diagnostic errors.
• Lack of reliable systems. For example, hospitals that don’t have clear protocol for following up with patients on test results could be more likely to issue a delayed diagnosis.

In order to prevent diagnosis errors, study authors concluded a strong first step would be to make sure doctors and other health care workers know when they were wrong. Often, unless there is a lawsuit, clinicians are not aware that a diagnostic error occurred. Regular feedback to doctors and hospitals is essential in helping them to understand where they may have gone wrong in the process.

As stated earlier, it’s not enough for our Fort Lauderdale attorneys to show that a patient suffered a serious illness or even that the doctor was wrong about diagnosis. In these specific medical malpractice lawsuits, patients must prove that a physician in a similar specialty and under similar circumstances would not have made the same failure to diagnose a condition.

This ultimately requires the testimony of an expert witness who is similarly educated/ situated as the doctor/ defendant. However, our injury lawyers will first look at something called the “differential diagnosis” method. This is the protocol the doctor used to make his or her treatment recommendations.

The differential diagnosis is a type of systemic method physicians will use to figure out if a patient has a certain condition, or to rule it out. The doctor conducts a preliminary evaluation, makes a list of probable diagnoses and then tests the strength of each. This process of investigation will hopefully yield a single, correct diagnosis at the end, though that is never guaranteed.

In alleging a diagnostic error, patients need to show:

• Physician failed to include the correct diagnosis in the original differential diagnosis list, even when a reasonably skilled doctor under similar circumstances would have done so;
• Doctor included the right diagnosis but did not perform appropriate tests or seek specialist’s opinion in order to thoroughly investigate the likelihood of that condition.

In cases of missed or delayed diagnoses, we might also show deficient procedures led to failed communication, which resulted in missed opportunity for appropriate treatment.

Contact Fort Lauderdale Attorney Richard Ansara at The Ansara Law Firm by calling (954) 761-3641.