Diagnostic error leads the way in instances of medical negligence as well medical malpractice lawsuits. Heart attack (myocardial infarction) misdiagnosis, along with cancer, the most frequently misdiagnosed condition.
In order to avoid the often deadly consequences of a failure to detect a heart attack, clinical practice guidelines have been established. These guidelines call for specific diagnostic procedures that are dependent upon the condition and symptoms of the patient.
Diagnostic Rules are Important to Follow
Clinical practice guidelines have been established for many areas of medical service. The guidelines provide for uniform procedures to minimize medical error.
In light of the scale and scope of preventable medical error, which causes up to 440,000 deaths each year, guidelines are important. Unfortunately, there are many medical providers that simply do not follow practice guidelines.
In the event of a heart attack, a failure to follow the diagnostic guidelines often has deadly results.
Breach of Standard of Care
Medical malpractice claims require a showing that the medical providers conduct fell below the standard of care in the community. The rule is typically construed as a locality rule meaning the standard is based upon the particular community.
In specialized areas of practice, the standard is typically nationally standard based upon guidelines established by the particular specialized medical industry group. The issue of failed diagnosis of heart attacks would seem to cross over depending upon the nature of the care provided (i.e. primary care, emergency care, specialist care and so on).
Primary, urgent, and emergency care will likely have elements of both local and national standards. However, where guidelines are established, such as the diagnosis of heart attacks, clear violations of the guidelines would likely constitute medical negligence.
Diagnostic Requirements Dictated by Condition of Patient
The level of diagnostics will be dependent upon presentation of the patient. This is in fact where many errors are made. The symptoms of the patient do not clearly indicate heart failure so additional testing is not done.
This would seem to make sense and this is often the response of the medical provider, i.e. the symptoms did not suggest additional diagnostics. This position is often taken and somewhat parrots the tort reform platform that too many unnecessary tests are conducted out of fear of lawsuits.
In fact, nothing could be further from the truth as evidence by the hundreds of thousands of American deaths caused each year by preventable medical error, with diagnostic errors leading the way.
Differential Diagnosis – Rule the Worst Out First
In those cases where heart failure goes undetected despite the patient’s best efforts, the records will often show that indeed additional testing was called for.
The differential diagnosis rule requires that the medical provider rule out the worst and most serious illnesses first. Heart failure would be among those illnesses where additional cautionary testing should be done.
This is particularly so since heart failure comes with many different indicators. They may not all line up the medical provider’s expectations regarding the degree and number of indicators that must be present.
Differential diagnosis addresses the vagaries that might be present requiring that the medical provider conduct the diagnostics necessary to rule out the most serious conditions such as heart failure.
Heart Failure Diagnostic Procedures Fall on a Continuum of Care
The basic physical exam and history are at the base of every examination regarding possible heart failure. From there, an escalation of various tests and diagnostics will be suggested depending upon the condition and symptoms of the patient.
The challenge in these cases is determining where on that continuum the patient fell in consideration of the differential diagnosis requirements. There are certainly those cases where it is simply a matter of judgment with the medical provider’s judgment getting the benefit of the doubt.
Like all medical malpractice cases, a failure to diagnose heart failure must be reviewed by a medical expert. Only a medical expert will be able to form a legitimate opinion as to whether the standard of care was met. And this standard of care will likewise be on a continuum depending upon the nature of the medical provider (primary, urgent, emergency, cardiology…).
Seek Legal Guidance Right Away
Like any medical malpractice case, claims for a failure to diagnose a heart attack have strict and unique deadlines.
These deadlines will vary depending upon whether the medical provider is public or private, and whether the provider is a qualified healthcare provider.
It is important to seek the guidance of an experienced medical malpractice attorney in order to understand the deadlines that will apply to your case. Missing a deadline will bar the claims completely.