Final Verdict: Diagnostic Error and Permanent Injuries
Medical malpractice attorneys are often confronted with instances of misdiagnosis that result in serious harm to patients. When a patient visits a physician, there is an expectation that the greatest possible care will be taken to carefully review symptoms and come to an accurate finding. Differential diagnosis, the process doctors use to come to a conclusion about medical conditions, isn’t just guesswork. There is a large volume of relevant literature which provides clear and repeatable steps to be followed when making a diagnostic decision.
Not all medical conditions are easily diagnosed; in some cases, the answer just isn’t very clear. In other cases, a patient may have multiple overlapping conditions with symptoms that make it impossible to pick out one specific condition over another. Under these circumstances, misdiagnosis or failure to diagnose is not medical malpractice. Liability arises when a patient receives poor or delayed care or the doctor fails to follow recommended guidelines in making the diagnosis. A doctor who ignores the literature and goes with a “gut” decision can be in serious trouble if he or she turns out to be wrong.
Certain medical conditions, like stroke or heart attack, have clear symptoms which demand immediate treatment. In these cases, even a few minutes of delay can greatly increase permanency of injuries or even make the difference between life and death. One such condition is acute appendicitis. When the cecal appendix becomes infected, failure to treat can result in rupture, which requires emergency surgery and exposes the patient to extreme risk of further infection.
On August 16, 2016, 77-year-old retiree Alexander Nelson came to Lewisgale Medical Center in Salem, Virginia with complaints of abdominal pain, vomiting, and general nausea. Although he had received a colonoscopy the previous day, the symptoms were not consistent with what typically follows a colonoscopy, and so a CT scan was ordered. Radiologist Matthew Wagner examined the CT scan and concluded that there was no emergency.
Two days later, Alexander returned with greatly increased symptoms and extreme pain. An additional CT scan shows that Alexander had been suffering from acute appendicitis and the appendix had ruptured. He had to undergo emergency surgery, leading to blood clots in his legs and lungs as well as a septic infection and respiratory failure. Brain damage resulted in permanent communication difficulties and he had to undergo a lengthy period of physical therapy and rehabilitation.
Attorneys for Alexander brought suit against the Radiology Associates of Roanoke, Dr. Wagner’s company, arguing that the acute appendicitis was clearly evident on the CT scan and Dr. Wagner had failed his duties in his misdiagnosis. During the eight-day trial, experts hired by Radiology Associates claimed that appendicitis directly after a colonoscopy was rare, and so Dr. Wagner didn’t fail to meet ordinary standards of care by failing to realize it. However, the jury was unconvinced. Alexander’s attorneys brought experts who explained that Dr. Wagner had only been practicing for two weeks and that his notes indicated he saw abnormalities but failed to report them to anyone. The jury agreed, and awarded Alexander $1.5 million in damages for medical malpractice. Cohen & Cohen
