Malpractice Case: Why You Should Follow Through on Your First Suspicions

Gordon T. Ownby


August 10, 2020

Though the patient missed an appointment scheduled for 5 days following the original visit, no one at Dr FM's staff attempted to contact the patient to inquire of his condition.

Three days after that, the patient was found dead in his apartment. An autopsy noted the cause of death as "peritonitis due to ruptured bowel." A dispute asserted against Dr FM by the man's survivors was resolved prior to the initiation of an actual lawsuit.

A recurring theme arises when reviewing closed medical professional liability claims, and that is the litigation risk when a physician fails to follow through on his or her first instincts when assessing a patient. The risk management lesson in these cases is not, of course, that a physician cannot change his or her approach to treatment. Rather, the takeaway is that when changing course, the record needs to show diligence in exploring the initial suspicion — especially in those cases where the first instinct turned out to be the correct one.

Here, the record showed that Dr FM, by ordering the ultrasound, had decided that he would explore beyond the possibility of simple food poisoning. But though the ultrasound findings were not particularly alarming, Dr FM's choice to not timely contact the patient with the results, or follow up with a CT scan if the patient was still ill, certainly would be exploited at trial. And by waiting for a week for lab results — which did include significant WBC and glucose values — Dr FM would be exposed to a plaintiff attorney's argument that he did not adequately follow up on his initial plan.

Again, this is not about being locked into any particular treatment plan. It is about diligently pursuing each prong of a plan to confirm an earlier suspicion or to defend a change in course.

This case comes from the "Case of the Month" column featured in the member newsletter published by the Cooperative of American Physicians, Inc. The article was originally titled "Following Up on First Impressions."


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