By Megan Stanley
Failure to diagnose or a delay in diagnosis of medical conditions is one of the most common complaints we have from clients when it comes to medical services. Delay in treating a medical condition can be devastating for a patient.
In this article we will look at health providers' obligations, the importance of diagnosis and diagnosis when it comes to more serious conditions such as cancer. We also outline a case study where a doctor's report was found to be negligent and ultimately the cause of a delay in diagnosis of bowel cancer.
What are the health provider's obligations?
Health providers have a duty to exercise reasonable care and skill when providing advice and treatment. This duty extends to the examination, diagnosis and treatment of the patient and the provision of information.
Patients have various rights and should be given appropriate information about the potential risks of a procedure or treatment to allow them to make an informed decision about whether to go ahead with the recommended procedure or treatment.
How does diagnosis fit into the picture?
Accurate and timely diagnosis of a medical condition is needed to determine what procedure or treatment is required to rectify or ease the medical complaint.
Health providers have available to them a multitude of investigations to assist in diagnosing medical conditions. Complaints made by a patient, as well as signs and symptoms, should allow health providers to determine what investigations are required to assist with diagnosis.
Investigations are undertaken not only to assist with making a diagnosis but also to eliminate medical conditions.
Although it would seem reasonable to assume that a bone fracture is a straightforward condition to diagnose, we have seen matters where there has been a delay in diagnosing and treating a fracture due to a failure to refer the patient for a scan, which has ultimately compromised the patient's recovery.
What about more sinister medical conditions such as cancer?
Colon cancer is one of the most common cancers suffered by adults in Australia and because of this, there is a national screening service in Australia. Studies indicate that early detection, such as by faecal occult blood screening, can lead to a reduction in mortality. Screening has the potential for diagnosis even at a pre-malignant stage. Polyps in the bowel can become cancerous and if the polyps are identified at an early stage they can sometimes be removed via colonoscopy before they turn malignant.
Early detection of such conditions is ideal. For example, if colon cancer is detected at an early stage before penetrating the muscle of the bowel, then prognosis for the patient is considered more favourable. Further, early detection may avoid the need for more invasive treatments such as chemotherapy.
Case studyIn the recent decision of Mazza v Webb [2011] QSC 163, the Supreme Court of Queensland was critical of medical services provided by a specialist doctor (the defendant). The patient (the plaintiff) had symptoms of vomiting, abdominal pain, diarrhoea and weight loss and was referred to the defendant for investigation. In February 2004 the plaintiff underwent an endoscopy conducted by the defendant. Following the procedure, the defendant provided a report to the plaintiff's GP indicating that the endoscopy was normal, although it had revealed villous atrophy, consistent with continuing coeliac disease. Ongoing symptoms resulted in the plaintiff undergoing a further endoscopy in May 2005 revealing a small bowel carcinoma, which was removed. The plaintiff required chemotherapy. The Court was not satisfied that the defendant had breached his duty to conduct a more extensive endoscopy in February 2004, however, considered that reasonable care required that the defendant inform the GP, and the plaintiff, that his investigation had been limited and that it had not provided a satisfactory explanation for the plaintiff's symptoms. The Court concluded that the defendant's report was negligent and that his negligence, by reporting as he did, was causative of the plaintiff's damage. The delay in diagnosis had extended the plaintiff's recovery. The plaintiff was awarded damages. |
Advances in medical science and the increased ability for patients to access a wealth of information via the internet will hopefully lead to a reduction in complaints involving a failure to, or delay in, diagnosis.
Importantly, as a patient you have the right to ask questions about your medical condition or symptoms, and have the right to seek a second opinion, particularly if you are not satisfied with the medical services provided by a health provider.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.