Misdiagnosis Leads to Amputation
A recent ruling from the Court of Queen’s Bench in Alberta confirms that prompt diagnosis can mean the difference between life and death (or in this case, life and limb).
Alberta farmer Wayne Forsberg has been awarded 1.5 million dollars in compensation as a result of medical negligence on the part of emergency room physician Dr. Dadi Naidoo.
Patient Suspected an Infection
In October 2000, Mr. Forsberg began to suffer from fever, stiff neck and a rash. He suspected that he might be suffering from meningitis because public health officials in the Edmonton area had been warning the public about a recent outbreak.
Forsberg attended the emergency department at the nearest hospital in Leduc.
The emergency room nurse who performed the triage suspected Forsberg was suffering from a blood infection and advised the attending physician, Dr. Naidoo. The nurse testified at trial that she asked Dr. Naidoo twice if the patient should be given antibiotics but was instructed to hold off.
Doctor Wanted to Wait
Dr. Naidoo testified at trial that he realized Mr. Forsberg probably had a blood infection but felt that he needed to discuss the issue with an infectious disease specialist before prescribing antibiotics.
Failed Attempts
The specialist Dr. Naidoo consulted with suggested a lumbar puncture which would help narrow it down the possible diagnosis. Dr. Naidoo tried unsuccessfully to perform the puncture on two occasions, resulting in further delay.
More than three hours after Mr. Forsberg arrived at the hospital he was finally transferred to Edmonton’s Royal Alexander Hospital where he was immediately started on antibiotics.
Unfortunately, as a result of the blood clots created by the meningitis bacteria surgeons had to amputate large parts of both of Mr. Forsberg’s legs and one of his arms.
Justice Dennis Thomas stated:
When faced with a “very ill man” Dr. Naidoo knew that a probable cause was bacterial infection and that there was literally nothing to lose by a very prompt attempt to treat that possible infection with antibiotics. Any medical professional should clearly have known that was the case.
Prompt Treatment Would Have Limited Injuries
Justice Thomas concluded that if Mr. Forsberg had been started on antibiotics immediately he would have lost his toes and perhaps needed some skin grafts but he would have avoided from having to suffer from the major amputations of his legs and arm.
Mr. Forsberg was awarded $270,000 for non-pecuniary damages for pain and suffering and over $1 million dollars to compensate for business losses as a result of him having to sell his farm.
Prompt and Effective Treatment Critical
This case highlights the pressures on emergency room staff to effectively triage and diagnosis potential illness.
Differential Diagnosis Method
When diagnosing a potential illness doctors are supposed to use what is called the “differential diagnosis” method.
Basically the process requires the doctor to create a list of all the possible causes of the signs and symptoms that the patient suffered from.
The doctor is then required to conduct tests or investigations to rule in (or rule out) the potential causes until the doctor arrives at a final diagnosis.
Dangerous or life threatening illnesses are supposed to be placed at the top of the differential diagnosis list because, as the Forsberg case illustrates, they can have dire consequences.
More Information
“What is a Differential Diagnosis and Why is it Critical to My Care?”
Want to Know More About Emergency Room Errors?
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