Medical Malpractice Attorney

Emergency Room Errors - The differential diagnosis

Every year hundreds of people are sent home from hospital emergency rooms only to die or suffer serious permanent injury from the very ailment they complained of to the hospital emergency room in the first place. In these cases the failure of the emergency room doctors and medical personnel to properly diagnose and treat the ailment may be a result of substandard care. In turn substandard care leading to death or serious permanent health consequences may form the basis for a medical malpractice law suit. This brief paper summarizes medical malpractice and the duty emergency room personnel in these circumstances.

All emergency room medical providers have a duty to provide reasonable medical care to patients who come to the ER for help. Reasonable medical care is defined as what the average medical provider is expected to do under the same or similar circumstances.

In many cases in emergency medicine the key to reasonable care is in the concept of differential diagnosis. Essentially, a differential diagnosis is a list of all possible ailments the patient may be suffering from given their presenting signs and symptoms. For example, if a patient comes to the ER complaining of severe abdominal pain the differential diagnosis will normally include indigestion, blockage, appendicitis, ulcer, or abdominal aortic aneurysm among other things. The differential diagnosis may be different according to the history and background of the patient. For example older patients may require a different range of potential conditions than younger patients.

The standard of care then imposes on the treating emergency room personnel, typically the emergency medicine doctor, to rule out those conditions which might be life threatening. In our example they would include: appendicitis, abdominal aortic aneurism or a perforated ulcer.

The standard of care requires the ER doctor to make reasonable diagnostic efforts to rule out these life threatening conditions. If the life threatening condition should have been on the differential diagnosis list and was not and/or the patient leaves the ER and later dies or sustains serious permanent injury as a result of the failure to diagnose and treat the life threatening condition, the ER doctor and hospital may be liable for medical malpractice.

The significant issues in these types of cases include: whether the duty of care required the life threatening condition to be included in the differential diagnosis based on the presenting signs and symptoms; whether the duty of care required additional diagnostic treatment to determine whether the life threatening condition was present; and whether proper timely treatment would have saved the patient's life or avoided serious and permanent injury.

There are many more issues to consider in these kinds of cases and it pays to discuss them with an experienced medical malpractice attorney. The attorneys at Van Dorn & Curtiss have many years experience handling all kinds of medical malpractice cases. Please feel free to contact our Concord medical malpractice attorneys if believe you have a case to discuss.  We serve the New Hampshire and Vermont areas including Nashua, Concord, and Manchester.