Understanding Failure To Diagnose In Reid v Hanafi [2026] TASSC 46

The Supreme Court of Tasmania recently delivered a medical negligence decision in Reid V Hanafi [2026] TASSC 46. The case considers whether general practitioner Dr Robina Hanafi failed to diagnose or refer for investigation symptoms that were later recognised as manifestations of multiple sclerosis.

The decision illustrates the difficulty of identifying serious neurological disease when a patient presents over time with a range of symptoms that, viewed individually, may appear common and non-specific. It also reinforces that the standard of care is assessed by reference to the information available to the practitioner at the time, rather than with the benefit of hindsight.

Background

The plaintiff, Ms Wendy Reid, first attended Dr Hanafi’s practice on 22 April 2014. Over the following 16 months she attended the practice on 12 occasions before ultimately being diagnosed with MS after a dramatic deterioration in August 2015. A central issue at trial was whether the symptoms reported during those consultations should have prompted neurological investigation or referral at an earlier stage

It was for these reason that the chronology was critical.

At the first consultation on 22 April 2014, Ms Reid complained of neck and back pain, shoulder pain and tingling in her hands and feet. Two days later she returned to discuss blood test results, which revealed a vitamin D deficiency.

Several months later, on 22 September 2014, she reported constant dizziness, pressure in her head and fatigue. At a further consultation on 6 November 2014, dizziness was again discussed together with anxiety and hyperventilation symptoms.

During early 2015, Ms Reid attended for smoking cessation assistance and stress-related concerns on 24 February and 7 April 2015. On 4 May 2015 she complained of headaches, facial pain and oral thrush.

Ms Reid contended that throughout this period she consistently reported tingling and sensory symptoms suggestive of developing MS. However, the defendant maintained that such symptoms were reported only during the first consultation and then again shortly before the diagnosis in August 2015. This factual dispute became one of the key issues at trial.

The plaintiff’s condition became more concerning during mid-2015. On 7 July 2015 she attended for a mental health review. By 4 August 2015 she reported tiredness and weakness in her legs. On 12 August 2015 she complained that both her arms and legs were weak, her walking had been affected, she was experiencing incoordination, neck soreness and tingling in her hands and feet, and was largely housebound. When she returned on 17 August 2015 with worsening weakness, abnormal gait and persistent tingling, an urgent referral was arranged. MS was subsequently diagnosed.

Issues

The case turned on four key questions:

1. what occurred during the plaintiff’s consultations with the defendant,
2. what constituted competent medical practice in the circumstances,
3. whether the defendant breached her duty of care, and, if so,
4. whether that breach caused the plaintiff’s loss.

Decision 

A substantial aspect of the judgment concerned the operation of section 22 of the Civil Liability Act 2002 (Tas), which provides a defence where a professional acts in a manner widely accepted by peer professional opinion as competent professional practice. The Court considered expert evidence from both sides regarding the significance of the symptoms reported and the circumstances in which referral to a neurologist was required.

Her honour also considered both causation and breach as part of her decision.

The Court was not satisfied that the plaintiff had reported sensory symptoms at every consultation, as alleged. Her Honour considered that the recorded presentations comprised of “a range of non-specific symptoms, many of which are commonly encountered in general practice” and found it was not inappropriate for Dr Hanafi to pursue differential diagnoses that did not include a neurological condition. Referral to a neurologist was not indicated until 12 August 2015, when it actually occurred, and accordingly Her Honour was not satisfied on the balance of probabilities that the defendant breached the modified standard of care towards the plaintiff on any occasion on or after 22 April 2014.

Her Honour further found that the plaintiff failed to establish that any delay in diagnosis caused her alleged loss. Although an earlier referral may have led to diagnosis and treatment by April or May 2015, the Court was not persuaded that earlier treatment would have prevented the August 2015 deterioration or the subsequent development of progressive disease.

Accordingly, the proceeding was dismissed.

Although liability was not established, Her Honour assessed damages on a hypothetical basis. The assessment included $150,000 for non-economic loss, approximately $315,000 for past economic loss and superannuation, approximately $411,000 for future economic loss and superannuation, and $472,774.25 for future gratuitous care.

Conclusion

The decision highlights that, in delayed diagnosis cases, courts will closely scrutinise exactly what symptoms were reported at the time and will assess clinical decision-making against the circumstances confronting the practitioner then, rather than through the lens of a subsequently established diagnosis.