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Seattle Medical Malpractice Law Blog

Fat-shaming from doctors can result in failure to diagnose

Doctors are humans, which means that they make mistakes. They also have prejudices and personal opinions that can impact the quality of care patients receive. While codes of ethics at most hospitals preclude a doctor from refusing to treat patients because of the color of their skin or religion, those who are obese or extremely obese may face overt discrimination.

Many people who are overweight or obese have experienced a doctor ignoring serious symptoms. Instead of exploring other potential causes, doctors biased against overweight patients may assume that everything from irregular heartbeats to serious pain is simply a result of the patient being overweight. That can result in a failure to diagnose serious issues, such as potential heart failure, cancer and a host of other potentially life-threatening conditions.

The details of misdiagnosis

With the devastating effects cancer can have on the body, a proper and timely diagnosis can make the difference between life or death. Washington, as well as the rest of the United States, does not hold all doctors accountable for misdiagnosis. In order to prove a diagnosis error, patients must prove that the doctor was negligent when he or she should have detected the illness, or show that the doctor properly diagnosed the illness but failed to provide adequate care.

The New York Times covers one corner of the all-too-frequent occurrence of cancer diagnosis errors. Reports show that many patients are fearful they may choose inefficient oncologists and surgeons, whether that inefficiency stems from lack of training, negligence or other type of medical misstep. A large majority of patients have a growing mistrust in the health system because of the common occurrence of cancer misdiagnosis, and since the disease can prove difficult to treat, most individuals must make appointments with multiple doctors. Generally, cancer patients must receive treatment from surgeons and specialists in radiation and chemotherapy. Properly diagnosing cancer can be extremely difficult, and often requires a series of appointments involving biopsies, insurance and therapy sessions.

Surgical errors: a matter of trust?

Doctors handle some of life's most crucial moments, which means they also stand as knowledgeable and experienced professionals that a community can trust. While a large majority of physicians and surgeouns are successful and loyal health professionals, some, unfortunately, are not as reliable. Studies and reports point toward various reasons why some Washington medical professionals simply cannot be trusted.

One factor leading to surgical errors in the area could be due to a lack of experience. The Washington Post highlights the ongoing debate around surgeons with minimal expertise performing high-risk procedures. Many of these cases arise from hospitals that lack experience caring for a significant number of patients. The news article also delves into studies showing that patients were more likely to have successful surgeries from surgeons who performed the surgery 25 times or more a day, as opposed to doctors who were less familiar with the procedure. While practice does not necessarily make perfect, such studies show that surgeons became more efficient at a particular procedure the more they performed that procedure.

Understanding the ED triage process

People in Seattle may hear stories about patients dying in emergency department waiting rooms and worry that they might face the same scenario were they to present to the hospital in an emergent event. Many have developed a “first come, first serve” mentality when it comes to waiting for services (including health care). However, visits to the ED are not supposed to work the same way. Of the 130.4 million ED visits that the Center for Disease Control and Prevention reports occur annually, it may be reasonable to assume that not each of those share the same level of acuity. So how are ED providers to determine who should be seen first?

According to the Agency for Healthcare Research and Quality, an emergency severity index is used during the ED triage process. The index dictates the decision-making of ED triage nurses in order to assign an appropriate level of acuity to patients. The ESI triage process proceeds as follows:

  •          Does the patient require immediate life-saving intervention? If so, he or she needs to be seen immediately.
  •          Is the patient in a high-risk situation, feeling confused, lethargic or disoriented, or experiencing severe pain or distress? If so, then he or she should be placed in the next available ED bed.
  •          How many resources are needed to deliver care? Vital signs are included in these resources, the results of which could bump one up to a higher severity index.

When a diagnosis is a misdiagnosis

In Washington, patients are diagnosed with medical ailments on a daily basis. Timely diagnosis of a serious and life-changing medical condition is imperative to taking steps towards proper treatment or even a cure if available. Yet, some patients are misdiagnosed and possibly at a greater frequency than many realize.

The National Center for Policy Analysis reports that it is estimated that up to 20 percent of diagnoses are actually misdiagnoses. Quantifying the numbers may be complicated by the fact that many doctors are not aware of an erroneous diagnosis under their watch, because a patient may change doctors or not learn of the true diagnosis for years to come. It is indicated that the vast majority of physicians believe that misdiagnosis is preventable, yet many are hesitant to anonymously report a misdiagnosis, even when risk of substantial harm is evident. Most incidents of malpractice due to incorrect diagnosis do not result in a lawsuit. However, misdiagnosis is nonetheless the number one cause of medical malpractice legal actions.

Off-label drugs and uterine tearing: Was your doctor to blame?

Pregnancy is typically a joyful and expectant time. Sure, there are unpleasant symptoms, like morning sickness and stretch marks, but most women still look forward to labor and delivery with growing excitement. For a small number of mothers, however, labor and delivery are where an otherwise healthy and perfect pregnancy can turn sour.

If a doctor decides to administer a particular drug for an unapproved purpose during labor, the potential health consequences are devastating. If the laboring mother-to-be has a bad reaction to the drug, it could prove fatal to her, her child or both.

Detailing cases of retained surgical instruments

Most in Seattle likely understand that surgical procedures are often complex, and thus may be more willing to give surgeons the benefit of the doubt when the more difficult aspects of a procedure go wrong. Yet at the same time, there is an expectation that the seemingly routine elements (such as ensuring that all surgical items and instruments are removed from a patient before an incision is closed) will not be overlooked. As difficult as it may be to believe, however, retained surgical instruments continues to be a problem plaguing the medical industry.  

Just how common are such errors? Data compiled by the Joint Commission and shared by CBS News shows that almost 800 cases of retained surgical instruments were reported in the U.S. between 2005 and 2012. While in most cases, the items left behind are surgical sponges or gauze, reports of syringes, skin retractors and even scalpels left in patients are not uncommon. No matter what may be left behind in a patient, all cases of retained surgical instruments are serious, Indeed, the Joint Commission report shows that 95 percent of patients reported as having retained surgical instruments required extended hospitalizations, while 16 patients were actually killed as a result of them.

Getting a second medical opinion

Even Washington residents who have had good relationships with their doctors over a period of years might find themselves in situations when they feel a second opinion could be useful. Knowing when to seek a second medical opinion as well as how to seek a second opinion is an important way of protecting oneself and advocating for one's own health.

As for when it might be appropriate to seek the input of another provider, WebMD offers some insight and guidance. Upon receiving a diagnoses that is serious and potentially terminal, getting corroboration from another doctor can be useful. Similarly, if a patient does not fully understand a diagnoses, talking to someone else is a good idea.

Detailing the potential for a stroke misdiagnosis

Many in Seattle may have a good understanding of the pressure that doctors are under to properly diagnose their patients. That pressure may be even greater in the emergency department, where the potentially grave situations physicians encounter force them to make split-second decisions. Still, it is expected that ED doctors exercise all due diligence in examining patients and interpreting their symptoms and results carefully in order to arrive at the right diagnosis.

Misdiagnosis of heart attacks in the ED often make headlines, yet another condition that might not generate the same level of publicity yet is equally as damaging is a stroke. Information compiled by the National Practitioner Data Bank and shared by AHC Media puts the potential of stroke patients being misdiagnosed at 9 percent, as opposed to only 2 percent for heart attack patients.

What is Erb’s Palsy?

If your child has been diagnosed with Erb’s Palsy in Washington, you may be wondering how this happened and what you can do about it. According to the American Academy of Orthopaedic Surgeons, this condition is actually a birth injury that is caused during a difficult delivery of a breech position or large baby or a delivery in which there was prolonged labor.