Medical malpractice or professional negligence

Medical malpractice or professional negligence

Medical malpractice or professional negligence occurs when a mistake by a healthcare professional leads to injury or death of a patient. The error may be due to carelessness or forgetfulness. Malpractice must meet three conditions before it can be proven: the mistake fails to meet accepted medical standards, causes injury that would not have happened had the practitioner not been involved and must result in substantial damages worth pursuing litigation for. The average number of lawsuits filed in the United States annually is 17,000, which translates to the average American doctor expecting a lawsuit once every seven years (Chima, 2016). Diagnostic errors result in the highest number of malpractice lawsuits. The impact of a malpractice lawsuit to a practitioner is not only financial but can also affect their reputation and emotional well-being. Some of the recommended practices to avoid medical malpractice lawsuits include effective communication with patients, documentation, informing consent to patients, updating law standards, and follow-up. Below is a review of three actual malpractice lawsuits.

Case 1: Failure to Perform an X-ray

Each year, starting in 1995, an associate professor took a comprehensive physical exam at the University clinic as required by the terms of his contract. Due to the age of the professor and his history of heavy drinking, the physician who first examined him ordered a chest x-ray. The results showed a small nodule in the periphery of the right middle lobe, which the radiologist suggested was probably benign. Chest x-rays taken over the next two years showed no change in the size of the nodule. However, in the 1998 examination, the attending practitioner, Ms. F, failed to perform a chest x-ray after the patient raised concern on the amount of radiation he was exposed to. Within a year, the patient died after unsuccessful treatment following a diagnosis of stage 3 large cell carcinoma of the right lung. The family sued Ms. F for “gross negligence and incompetence.”

Informed consent is the pillar of patient-centred care, an approach to medical care, where patients actively participate in their treatment. Physicians, on their part, educate patients for them to have adequate information to make decisions that reflect personal preferences and values (Murray, 2012). In this case, as part of informed consent, Ms. F was required to inform the professor about the importance of taking an x-ray despite concerns about exposure to radiation. She was to tell him of the potential risks of failing to do so. If the professor insisted on not taking the test, then she was to obtain written informed consent from him, indicating the same. The presence of written informed consent from the professor would be sufficient evidence to protect her against the accusation of negligence and incompetence.

Case 2: A Defective Call back Policy

A young girl was brought to the clinic with a 24-hour history of fever, vomiting, and diarrhea. Ms. L examined the child, diagnosed her with a viral syndrome and gave the parents printed instructions on fever control, hydration, monitoring her temperature and returning her to the clinic if her condition did not improve after 24 hours. The condition of the child worsened within 24 hours, and when the parents called the clinic twice within that period, a nurse discouraged them from returning the child to the clinic. The girl was later taken to the clinic’s other office, where the attending pediatrician discharged her despite noticing a rash on her chest and back. 24 hours later, the girl was admitted to the ICU and died a day after.

The clinic callback policy and misdiagnosis by the pediatrician were to blame for the child’s death. The nurse discouraged the parents from reporting back to the clinic while the pediatrician failed to recognize that the presence of a rush indicated a dangerous infection. Ms. L’s documentation was up to standards and helped her accurately reconstruct the events during the visit and enabled her to defend her actions. Despite providing the parents with instructions to the parents to callback if the child was not getting better, the nurse who answered the call failed to recognize the seriousness of the situation and discouraged the parents from bringing the child back to the clinic. The clinic callback policy stated that patients not feeling better should report back after 48 hours, a policy that was not appropriate in this case. The clinic needs to change its call back policy and enable clients who call back to communicate with the practitioner who attended them (Chima, 2016). Additionally, the case illustrates the importance of good documentation and the need for proper follow-up.

Case 3: Misdiagnosed Heart Attack

A 39-year-old man presented to the clinic with a sore throat and muscle pain across the back of his shoulders with the pain sometimes extending to his arms and legs. The practitioner, Ms. L, diagnosed him with a viral infection and prescribed amoxicillin. The client called two days later to report that there was no change in his symptoms, but the practitioner assured asked him to be patient and that the infection would have to run its course. Two weeks later, the client was admitted to the ER, where tests suggested acute anterolateral myocardial infarction. Then the client sued Ms. L for misdiagnosis after she missed the cues for cardiac pain and caused the patient to proceed to a massive MI. Ms. L was unable to defend herself as her she did not have accurate medical noted that contradicted the claims of the patient.

Ms. L made three mistakes. First, misdiagnosing muscle pain as a viral infection. Second, failure to accurately document her encounter with the patient as revealed during dispositions. Ms. L wrote brief notes and did not write down all the symptoms exhibited by the client or her justification for the diagnosis. Third, when the client called back two days later, she failed to follow-up, which would have given her a chance to correct her misdiagnosis. The three reasons clearly show that Ms. L was at fault. Had Ms. L made detailed documentation and followed-up on the case, then she would have a chance to correct her mistake and hence avoid a malpractice lawsuit (Chima, 2016).

Malpractice lawsuits are common in medical practice today. Although practitioners cannot avoid these unfortunate incidences, they can adopt practices that help prevent lawsuits. Some of these practices, as suggested in the cases discussed above, including informed consent, communication with patients, detailed documentation, and follow-up.