Over a period of 25 years (1986-2010), approximately 38.8 billion dollars were paid out by physicians and their insurance companies as a result of diagnostic errors. These errors were not only “wrong diagnoses,” but also included failure to diagnose or delay in diagnosis of a medical condition. Surprisingly, diagnostic errors are more common than surgical mishaps.
Diagnostic errors are dangerous because it may take months or even years to get the right diagnosis, once a wrong diagnosis is on the patient’s chart. Other times, a unreasonable delay of hours can mean the difference between a safe result and disaster for the patient.
Medical diagnosis is sometimes a difficult task for physicians, as there are always many different diagnoses (or “differential diagnoses”) to consider when a patient presents with a problem. Sometimes wrong diagnoses happen because the disease has not “presented itself” fully – the patient may see the doctor early in the disease process. However, sometimes the diagnosis is delayed or missed because the physician lacks the knowledge to make the diagnosis — or because the doctor fails to comply with the appropriate standard of care of a reasonably careful physician.
In those instances, when a reasonably careful physician should have made a correct diagnosis; when a physician ignores the safety of a patient; when a physician decides not to order certain tests to confirm a diagnosis; and the patient is injured as a result — that is actionable medical malpractice.
This problem is not infrequent in the emergency department, and the emergency department should be staffed with doctors who are trained to look for the life-threatening disease, when making a diagnosis for a patient who has, after all, been concerned enough about their symptoms to make a trip and usually has a long wait.
Common Examples of Diagnostic Errors
Examples of failure to diagnose in the emergency department include patients who have undergone CT scans to look for evidence of stroke. Ischemic, or non-hemorrhagic (bleeding) stroke is not evident on CT scan in the early stages of the stroke, and some clinicians fail to adequately test the neurologic function of the patient. All studies should be evaluated in concert with the clinical signs and symptoms displayed by a patient. In this case, the patient left the Emergency Department with weakness on the left side, because the doctor looked at the CT scan (which did not show the stroke yet – it was too early) and he failed to look at the patient. The weakness progressed to a left sided paralysis.
An example of diagnostic delay occurred when a radiologist failed to notice a spot on the chest x-ray of a patient, who returned 9 months later to his physician with metastatic lung cancer. The first chest x-ray was taken only because the patient had a cough, and since it didn’t show pneumonia, the radiologist and the patient’s doctor both failed to notice any other findings that were incidental on the chest x-ray. When they went back to look at the x-ray after the patient had been diagnosed with inoperable lung cancer, it was clear that the spot was present all along, and was probably the reason for the patient’s cough.
In both of these instances, failure to diagnose and delay in diagnosis had disastrous consequences. If you or a family member has suffered consequences like these as a result of a failure to diagnose or a delay in diagnosis, then you may have been the victim of medical negligence, and you should contact a Chicago medical malpractice attorney.
