Personal Injury Lawyer
In medical negligence lawsuits, the defense will throw every single defense against the wall to see if it will stick. They can be wrong nine out of ten times, but that tenth time can cost the plaintiff a verdict. There are stock defenses that defense lawyers use in every medical malpractice case when available. By contrast, if a plaintiff’s medical negligence lawyer were to make every possible argument, including contradictory ones, the jury would laugh him or her out of the courtroom immediately.
One common defense is the rare condition defense. It crops up in those cases when an individual has a rare medical condition or has an atypical presentation of a common medical condition. In these instances, the defense will argue that the doctor misdiagnosed the condition because it is not a common one or because the presentation was not classic. This argument is often faulty.
In virtually every case involving a missed diagnosis, such as a missed heart attack, pulmonary embolism, ruptured abdominal aortic aneurysm, cancer or vasculitis, the standard of care is dictated by the differential method of diagnosis. Every doctor is taught the differential method of diagnosis. It has several core principles. One core principle is that the doctor is required to establish the patient’s chief complaint, take a history and perform a physical exam. After completing these three steps, the physician should make a list of all potential medical conditions that could explain the patient’s symptoms. This is called the differential diagnosis.
Another core principle is that the physician has a duty to rule out those conditions that do not fit in explaining the patient’s symptoms. This can be done through testing, such as blood work, urinalysis and imaging such as MRI, CT scan or x-ray, genetic testing. EEG, EMG or other tests. The working diagnosis derived from the history and physical exam drives the testing required to rule in or rule out the final and correct diagnosis.
Another core principle is that when items on the differential diagnosis list are life-threatening, the physician has a duty to rule those in or out through appropriate testing first in order to save the patient’s life if it is at risk. Therefore, when heart attack or pulmonary embolism is on the differential list, the physician should move quickly to rule those items out since either one can cause immediate death.
Frequently, a misdiagnosis occurs because the physician jumps to conclusions or skips portions of the workup in establishing a differential diagnosis. The physician may rule out serious, life-threatening medical conditions based on a hunch or the failure to fully listen to the patient.
A rare condition or an unusual presentation of a common condition may or may not furnish a valid excuse for a physician’s failure to diagnose. If the physician does not create a complete differential list or rules conditions out without appropriate testing or inquiry, then the doctor may not have a valid excuse for failing to come to the proper diagnosis.
A misdiagnosis can have devastating consequences. The misdiagnosis can result in a delay in treatment or a delay in diagnosis. Delayed treatment or delayed diagnosis can result in a medical condition progressing from an early, treatable stage to a later, deadly stage. Thus, when confronted with the rare cause defense, your medical negligence lawyer will look to the differential diagnosis to see if in fact the misdiagnosis was warranted.