Differential Diagnosis and Medical Malpractice

As a medical negligence lawyer, I frequently deal with cases involving misdiagnosis, wrong treatment, delayed diagnosis or delayed treatment. In these cases, the delay results in harm by allowing a medical condition to progress and become more acute, more severe and more dangerous. For example, in the case of cancer, a delay in diagnosis may allow cancer to progress from an early, curable stage to a later, terminal stage that cannot be cured. Likewise, in the case of an infection, an infection can progress from an early treatable local infection to septic shock and multi-organ failure if source control and antibiotics are not given early in the process to stem the inflammatory response.

In these cases, and many other medical negligence cases, the use of the differential diagnosis is an important consideration. Every doctor is trained in the use of the differential diagnosis. It is an essential part of the medical process, meaning it is required by the used. The differential diagnosis is a method taught to all physicians which begins by taking all available information, such as the patient’s chief complaint, the patient’s medical history, risks factors, the oral history taken from the patient about the nature and onset of their current problem, a physical examination and the results of tests. Tests might include blood work, other lab tests, bacterial cultures, x-rays, CT scans, MRI, ultrasound and a host of other diagnostic procedures or tests. Based on this wealth of information, the doctor is trained to create a list of potential diagnoses that might explain the patient’s complaints and symptoms. This list is called the differential diagnosis.

Sometimes, the doctor will identify the differential list in their written documentation in the patient’s chart or hospital progress notes. Other times, the differential diagnosis is a thought process that is not recorded in the patient’s chart. In those instances, the differential diagnosis can be reconstructed by looking at the type of tests that were pursued and the doctors’ assessment and treatment plan. In any event, in every case, the doctor must create a differential diagnosis.

Another essential part of the differential diagnosis method of diagnosing a medical condition is the process of ruling out unrelated diagnosis. A doctor should rule out conditions on the differential list when the clinical symptoms or test results support ruling out that condition.  In the setting of a medical emergency, the physician should rule out those life-threatening conditions early in the process or risk the patient’s life.

Many medical malpractice cases arise from physicians’ failure to utilize the differential diagnosis. This occurs when a doctor cuts corners, does not listen to the patient, disregards the patient’s complaints or symptoms, or jumps to conclusions without adequate testing. As an experienced medical negligence lawyer in Cleveland, OH, like from Mishkind Kulwicki Law Co., L.P.A., knows, a careful review of the patient’s chart is necessary in these instances of underdiagnosis that leads to a delay in treatment or misdiagnosis leading to the wrong treatment.