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Medical Malpractice Case Review – Failure To Follow

Understand medical malpractice cases by looking at the facts.  This will be my first post that looks at potential explanations for preventable errors.  I say potential explanations because rarely, if ever, do we know why a doctor was negligent.

Case Review

A 60-year-old woman went to her PCP with abdominal pain, rectal bleeding, and fatigue.  The PCP referred her to a gynecologist.  The gynecologist performed an ultrasound and identified a likely uterine fibroid.  An endometrial biopsy was negative.  No other workup was performed.  The woman’s symptoms continued and, after several months, the PCP ordered an abdominal CT scan that revealed a malignant rectal mass.  It was stage IV rectal cancer and the woman died soon thereafter.

Discussion

The PCP failed to develop a differential diagnosis that looked at the most common causes of rectal bleeding.  Instead, the PCP appeared complacent and falsely reassured by the gynecologist’s benign findings.  Once the referral was made, critical thinking stopped.  Psychologists call this premature closure.  The PCP prematurely stopped the diagnostic process and did not order an additional workup because there were benign findings.  Again, the PCP ignored the most common causes of the woman’s symptoms.

Arguably, the PCP never engaged in critical thinking.  Deciding to refer the woman to a gynecologist allowed the PCP to make it someone else’s problem.

The vast majority of patients will be lucky.  The PCP’s negligence will not result in permanent injury or death.  However, where the patient is permanently injured or dies, the PCP should be held accountable.

This is not trial lawyer advocacy.  It comes from the nation’s largest physician-owned medical malpractice insurer, The Doctor’s Company.  The Doctor’s Company has a vested interest in eliminating preventable medical errors.   So do I.  Too many people have their lives catastrophically impacted by negligent doctors and health care providers.  No one should have to suffer because of another person’s carelessness.

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Joseph D'Aguanno

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