Articles Tagged with Failure to Diagnose

There are many types of conditions that fall under the umbrella of urology. They could be as minor as bladder infections and as severe as prostate cancer. Urology is the branch of medicine that deals with the urinary system of both males and females and all disorders related to it. It may also deal with the male reproductive system.

While New York residents may have found that their primary physician is able to deal with a lot of the minor issues they have when it comes to their urinary system, there are some situations where it may be important to see a specialist.

For example, if you see blood in your urine, this can be an early warning sign of kidney or bladder cancer. Doctors will likely do a urine test, look at the bladder with a scope and possibly perform an x-ray.

Cancer is everywhere and affects pretty much every family. In fact, the National Cancer Institute says one in two people will be diagnosed with cancer in their lifetime. That’s a very frightening reality. While there are numerous types of cancers, some can be much more devastating than others.

That’s why it makes sense that early diagnosis is very important. While sometimes symptoms are hard to detect, in many cases there are specific symptoms that a knowledgeable doctor can spot. Spotting those symptoms early and providing a proper diagnosis can save a person’s life.

If a doctor fails to notice these symptoms early, the cancer may progress quickly and eventually lead to death. Family members may wonder how something like this can happen and where they can turn for help. Although some families may feel uncomfortable accusing a doctor of medical malpractice, it may be warranted. The hope is that the medical professional learns from the incident, and that a similar tragic incident doesn’t hurt another family.

While we often talk about the different types of mistakes medical professionals make when caring for a patient, there is also a big concern when a medical professional fails to do something. In the case of one prison inmate in New York, this was a failure to diagnose that eventually led to his death.

Recently, a judge awarded the deceased man’s family with $1.75 million for the “extended physical and mental pain and suffering” endured by the man and his family. The judge found that the state, which was in charge of the man’s medical care while he was in prison, fatal consequences.”

In 2009 the man repeatedly complained about severe pain in his abdomen. He was initially diagnosed with kidney stones, and a physician recommended that he be seen by an urologist. While the doctors at the correctional facility were aware of the recommendation, they never referred him to the urologist. It was only in late 2011 when the man’s urothelial cancer was found and treated. Although he was cancer-free for a short time, the cancer returned in his lymph nodes in 2013 and he passed away in 2015 at the age of 58.

In a prior post, we highlighted the practice, as well as the dangers of off-label marketing. For those unfamiliar with the practice, off-label marketing (or use) is when doctors prescribe medications for uses that they were not intended for, or approved of by the U.S. Food and Drug Administration. Because of the long and arduous process of gaining approval through the FDA, off-label marketing and uses has become commonplace. A prime example of a successful off-label use is Viagra, which was initially intended as a drug to lower blood pressure, but is now the most famous erectile dysfunction drug in the world.

Another example of off-label use is OxyContin for juveniles. OyxContin is a version of oxycodone, which is a powerful, opiod-based painkiller. Because OxyContin is so powerful and highly addictive, the FDA had not previously approved it for use in young people under the age of 18. 

However, the drug’s manufacturer, Purdue Pharma LP, conducted clinical trials and submitted data to FDA regarding its findings on OxyContin use in young people. Essentially, since the drug has been reformatted, it is less likely for it to be abused by being crushed or dissolved so that it may be taken through the nasal passages or intravenously. As such, the FDA has approved it for young people.

In a number of our posts, we have noted how medical malpractice is one of the leading causes of death in hospitals. Indeed, there is much that can be done on the physician’s side that can prevent such deaths (especially through misdiagnoses), but patients can also protect themselves from doctors who deviate from established protocols or who do not take adequate time to properly diagnose a condition.

This post will identify a few steps patients can take to stand up for themselves and avoid the potential for medical malpractice. 

Educate yourself – In the past, knowledge on medical conditions used to be scarce. Only a trip to the library or having a personal relationship with a doctor would help in learning about your condition. Now, a quick search on the Internet can bring you enough knowledge to help you understand what you need to know.

In our last post, we highlighted the potential for better patient care if safe harbor provisions were followed and allowed to be incorporated into useful legislation. One of the notions behind safe harbors was that doctors commonly ordered tests that were not necessary or were created out of fear of future medical malpractice lawsuits.

A recent medicalnewstoday.com report supported this notion. According to researchers who surveyed  emergency room physicians, a majority of doctors in this area do indeed order unnecessary tests. One physician interviewed explained that doctors feel as if they have a tremendous pressure not to be wrong when making diagnoses; thus leading to non-medical reasons for diagnostic tests.

 In fact, more than 80 percent of doctors surveyed believe that their departments require too many tests, and nearly all doctors indicated that “medically unnecessary” radiology tests ordered would not be performed but for department regulations. Moreover, the tests are not based on doctors not being able to discover the cause of an ailment. Rather, it is the fear of medical malpractice suits that drives the culture of over-testing.

One of the clinical paradoxes facing doctors is determining when to use antibiotics to treat bacterial infections. The difficulty arises because some viral infections are indistinguishable from bacterial ones. When a doctor chooses to prescribe an antibiotic out of sheer caution, it could result in the creation of antibiotic resistant superbugs. The failure to use them could put patients at risk of infections, which could result in hospitalizations and increased healthcare costs.

Despite these difficulties, there are innovations coming that could help doctors in making informed decisions about how to treat patients. According to a medicalnewstoday.com report, a company has announced the results of clinical testing of a diagnostic blood test that would enable doctors to tell the difference between a bacterial and a viral infection. 

The test deviates from common pathogen detection by relying on the body’s immune response to determine the cause of the infection. Essentially, there are three distinctive proteins are activated by viruses and bacteria. The test incorporates an algorithm that when integrated, can create a unique signature that helps doctors understand what the accurate cause would be.

We have written before on the concept of defensive medicine and the monetary effect that it has on health care costs. Essentially, many doctors have become used to performing unnecessary tests to rule out potential conditions out of fear of being sued for malpractice down the road. This practice has been chronicled as one of the reasons for the dramatic and continuing increase in care costs.

However, in a number of states where medical malpractice reform has changed the standard in which patients must prove harm, it appears that doctors are still hedging their bets and relying on additional tests even when they are not required. 

According to a study conducted by research non-profit RAND Corporation, defensive medicine is still the norm despite changes in the law that basically grant immunity for some doctors; particularly emergency room physicians. The study compared data from Medicare patients from Georgia, Texas and South Carolina (three states that enacted malpractice reforms) and compared them to states that did not pass such reforms regarding quality of care (i.e. whether a physician ordered a CT scan or MRI, hospital readmissions, and total costs of hospital visits).

It is tough enough going to an emergency room after a serious injury, you shouldn’t have to wait an eternity in order to get medical attention. Unfortunately, patients can fall through the cracks in the midst of a busy trauma center, and may not be seen in a reasonable amount of time. When this happens, what may be a commonly treatable injury may progress into something worse and life threatening.

Such was the case of a patient who came to an emergency room complaining of a severe headache and excessive vomiting. The patient’s wife even informed medical personnel that he had recently been hospitalized for bacterial meningitis. He also had been diagnosed previously with deep vein thrombosis (DVT) and had been placed on blood thinners. 

For more than four hours the patient was not seen by a physician despite abnormal vital signs and laboratory readings. Soon afterwards, the patient fell into a coma. Indeed, the patient did not pass away, but a medical malpractice suit was initiated due to the failure to diagnose him in time to prevent a common ailment from progressing into something substantially worse.

While we have written a number of posts on injuries suffered through auto accidents, it is also important to realize that head injuries (particularly concussions) can be suffered through a number of ways. In fact, more than two million people will suffer head injuries severe enough to send them to the hospital  this year.

Traumatic brain injuries can be suffered through car accidents (i.e. heads hitting dashboards or windows), through sports injuries (particularly football and cheerleading accidents), and most notably, falls. Given the icy conditions that we live in, falls on slippery surfaces are common this time of year. 

However, being able to properly diagnose brain injuries is of particular importance.  Besides traditional bumps and bruises, it may be difficult to ascertain whether a person has suffered such an injury because of the subtle ways it may manifest itself. As we have mentioned in previous posts, not all people react the same way to head trauma. Some may have irregular sleep patterns, others may have intermittent headaches and others may have significant mood changes.