In my law practice as a Houston, Texas medical malpractice attorney, one of the most common medical errors I encounter is doctors skipping crucial steps in the process of making a diagnosis.
When a patient goes to see a physician in an emergency room, clinic, or office, the standard of care requires the physician to use the differential diagnosis process.
This involves the doctor listening to the signs, symptoms, and complaints of the patient, and then assembling a list of every potential diagnosis that could explain them. Then, the doctor must order tests or conduct assessments to rule out each potential diagnosis, starting with the most serious or life-threatening condition, before settling on a final diagnosis.
It is dangerous for a doctor to skip over the differential diagnosis process.
When a doctor skips any of these steps, it needlessly endangers a patient’s safety.
I am currently working on a case involving a man in his 40s who was in a car wreck in the Humble, Texas area. An ambulance took him to a local hospital emergency room. The nursing staff repeatedly documented in his medical record that the patient complained of left upper flank pain and right ankle pain and swelling.
When the emergency physician saw the patient, he recorded a differential diagnosis list that reflected a lack of proper consideration of the patient’s left upper flank pain. The doctor’s differential diagnosis list included: motor vehicle collision, head injury, trunk injury, abrasion, contusion, and sprain.
After an x-ray revealed that the patient had fractured the tibia bone in his right knee, the medical records reflected that he was quickly diagnosed with that broken bone, given some pain medications, and discharged from the emergency room with instructions to see an orthopedic surgeon. Before he was discharged, he and his wife asked if they would do an x-ray or MRI of his back, but he was repeatedly told no.
Unfortunately for this man, the emergency room workup was incomplete. When he went home, the pain in his upper flank got worse.
Within a week, his wife called an ambulance, which took him to another hospital, this time in the Lufkin area. In that facility, the doctors focused on a kidney issue. While he was at this facility, he told the doctors and nurses that he could feel pain in his arms and legs, but could not move them. He could still move his torso, but his arms and hands now had a claw deformity.
As a medical malpractice lawyer, I know that when the patient’s hand is in an involuntary club position, it is often a sign of a serious cranial nerve injury. The physicians of the hospital, though, did not include this possibility in their differential diagnosis lists and refused to order any imaging studies, like an x-ray or MRI. Instead of fulfilling its obligation to the patient, the second hospital and physicians on its medical staff discharged him to a nursing home for physical therapy.
While at the nursing home, a therapist eventually convinced a physician to order an MRI at an outside imaging facility. The radiologist immediately identified four fractured vertebrae that were compressing his spinal cord. He was promptly transferred to a third hospital, this time in the Kingwood area, for emergency spinal surgery.
Now, many months later, this man still has not regained movement in his arms and legs. His neurosurgeon told him that if the emergency physician at the first hospital had ordered an MRI or x-ray, then simple preventative measures, like steroid injections or a neck brace, would likely have resolved the issue. Now, he likely faces permanent, irreversible damage.
We are here to help
If you or someone you care for has been seriously injured as a result of misdiagnosis, call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free evaluation of your potential case.
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Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He represents patients and their families in medical negligence lawsuits. A former hospital administrator, Robert Painter was recognized, in 2017 alone, as one of Houston’s top lawyers, by both H Texas magazine and Houstonian magazine.
