When Missing a 'Zebra' Can Land You in Court

Mark Crane


February 20, 2018

In This Article

Rule Out the Worst Possibilities

"We don't take malpractice cases just because a doctor made a mistake," said Malcolm McConnell, a plaintiff's attorney in Richmond, Virginia. "Doctors are human. But was the mistake a reasonable one? Did the doctor do a proper differential diagnosis, prioritizing according to the likelihood and severity? A doctor had a duty to rule out potentially lethal or life-changing conditions."

McConnell represented a patient who died from hemochromatosis, where too much iron is absorbed, builds up in the skin and liver, and can lead to cirrhosis of the liver, cancer, and death.

"This patient went to his primary care doctor for routine blood tests at least once a year for 12 years," he said. "On every single study, his liver enzymes were elevated. I don't say that the doctor had to diagnose hemochromatosis, but he needed to follow up on why the liver enzymes were elevated, which he never did. When the diagnosis was finally made, the patient had cancer and died. If he'd been diagnosed earlier, the condition could have been managed. A confidential settlement was reached."

"In another case, we won a $6.5 million verdict for failure to diagnose myelitis," said McConnell. "The patient, an attorney in his early 30s, complained of numbness in his hands and fingers. Over several visits and phone calls over months, the primary care doctor wrote it off as anxiety. Not once did she do a neurologic exam. The patient is totally disabled."

"Physicians sometimes have a bias when they make a preliminary diagnosis," he said. "It's like they have blinders on. They don't maintain an open mind. If initial therapy isn't effective, you really have to do more to get to the bottom of the issue. If you follow proper protocols about testing and referral, she could have been led to the right diagnosis even if she never saw myelitis before. Doctors don't get a pass because it's a rare disease."


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