Malpractice Liability for Misdiagnosis

When does a misdiagnosis become an actionable medical malpractice claim?

Getting the right medical treatment often hinges on getting the correct diagnosis in the first place. So in cases involving a misdiagnosis or delayed diagnosis, patients might be within their rights to file a medical malpractice lawsuit, if a doctor’s negligence resulted in harm to the patient. But what does a patient need to prove in a medical malpractice case involving the misdiagnosis? Read on to understand how such a case might proceed.  

Establishing Liability

If a doctor fails to accurately diagnose a health problem, and that leads to a worsening of the patient’s condition, he or she may be liable in a medical malpractice lawsuit. In order to prevail in such a case, the patient (usually through a medical malpractice attorney) will need to establish a few key elements:

  • The existence of a doctor-patient relationship. This element is usually pretty easy to establish, even without relying on the detailed paper trail of medical records and bills that follow every patient through the course of their treatment.
  • The doctor’s medical negligence in failing to properly diagnose the patient.
  • Actual harm to the patient stemming from the doctor’s negligence in making a diagnosis.

Most misdiagnosis cases will turn on the issue identified in the second bullet point above -- whether the doctor’s inability to properly diagnose the patient rose to the level of medical negligence. It’s important to note here that a doctor isn’t automatically deemed negligent simply because a disease or other harmful health issue wasn’t spotted in time.

The key question is whether, in failing to make a correct and timely diagnosis, the doctor also failed to act with the competence that a reasonably skilled physician would have demonstrated under the circumstances. So, on the one hand there are diagnostic mistakes that any doctor would likely have made, and these likely are not compensable via a medical malpractice lawsuit. But on the other hand there are unreasonable errors in diagnosis -- health conditions that a competent doctor would have identified, in other words -- and these could likely form the basis of a medical malpractice claim. In the sections that follow, we’ll take a closer look at the difference.

Proving Medical Negligence in a Misdiagnosis Case

In trying to prove that a doctor made a negligent diagnostic error, a patient’s medical malpractice attorney will seek to demonstrate that a competent physician, under the same circumstances and when confronted with the same diagnostic information, would have made the correct diagnosis and avoided further harm to the patient. This kind of proof is no easy task, and it usually requires the assistance and sworn testimony of an expert medical witness.

Differential Diagnosis

When assessing a patient’s condition, physicians often rely on an organized process of elimination known as a differential diagnosis. After examining the patient and considering all possible health issues, the physician will perform tests to confirm or rule out each possibility, until one clear, definitive diagnosis remains. The differential diagnosis procedure that was followed in the plaintiff’s case will be examined by the plaintiff’s expert witness, and the expert will seek to establish two things using this differential diagnosis as a backdrop:

What was the appropriate medical standard of care under the circumstances? This is the measuring stick against which the doctor’s conduct is measured in any medical malpractice case. The question here is, what would a reasonably competent and skilled physician have done under similar circumstances? Specifically, what health conditions should have been considered in the differential diagnosis? What final diagnosis should have been arrived at?

Did the doctor breach the standard of care? If so, how? Once the standard of care is established -- what a reasonably competent doctor would have done -- the plaintiff’s expert will present a thorough analysis of what the doctor actually did. If the doctor missed something in the examination of the patient, in the consideration of potential health conditions, or in carrying out tests to rule out candidate conditions, this is where the expert establishes those errors.        

Other Considerations

Many factors play into the determination of negligence in a medical malpractice case stemming from a misdiagnosis. Some evidence may not directly involve the physician, but other medical staff, or even faulty diagnostic equipment. And in cases involving treatment in emergency rooms, urgent care requirements may impede the ability of a physician to conduct a thorough diagnosis, and those factors will need to be considered in assessing the appropriate standard of care. The complexity of a medical malpractice case -- from both a medical and legal standpoint -- merits at least a consultation with an experienced attorney, so that you can discuss the facts of the case and explore your options.

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