Should I report and/or sue this doctor?
February 14, 2011 10:35 AM   Subscribe

I know…YANMD, YANML. My daughter was born with an odd head shape and no fontanel. At three months our GP set up an appointment with a paediatric specialist. His diagnosis was, “that's just the way she was positioned in utero.” He did not schedule a follow up.

Over the next 15 months my wife kept mentioning our daughter's head shape at every appointment with our GP. The GP finally agrees to set up another appointment with the same specialist. This time he advises an X-ray. We have the X-ray at 20 months and see a neurosurgeon at 22 months. The neurosurgeon takes one look at her and says he doesn’t need an X-ray to tell that she has condition x. (Yes I'm being a bit vague here. It's enough to know that this is mainly cosmetic, but in some instances can cause neurological issues. If she doesn’t have the operation she’ll have to make yearly visits to the hospital to make sure there is no pressure on her brain.) He then describes the 10 hour operation she will need to fix her condition. He asks us why we didn't come earlier as most kids with her condition have the operation before six months. We tell him why and he says that GPs often miss it. We tell him that no, this was a specialist. He looks surprised but says nothing. He also tells us that if she had come in before six months the operation would have been much shorter and less invasive, however the results at this age are still good.

My question is should I report the first specialist? I should note that he teaches paediatric medicine at the local university and he is affiliated with the hospital where she was finally diagnosed. Also her condition occurs in 1 of 2000 births, so it's not exactly unusual. Is it worth the time and effort to report this to the local medical board and should I sue the doctor? Keep in mind that this is in Canada so the operation and one week hospital stay are completely covered.
posted by trigger to Health & Fitness (14 answers total)
Well, if you didn't believe the first doctor, which it sounds like you didn't, why didn't you push harder or get a second opinion? I mean it is your daughter and you and your wife are the main advocates for her, even when specialists drop the ball (which they do).

What would you get out of reporting or suing the doctor? What DO you want to get out of following up so aggressively?
posted by TheBones at 10:41 AM on February 14, 2011 [1 favorite]

What would you get out of reporting or suing the doctor?

One would hope that a reprimand would encourage the doctor to be more careful in treating future patients with the same condition, yes?
posted by Sidhedevil at 10:50 AM on February 14, 2011 [4 favorites]

I would definitely report it to the medical board. When one gets poor treatment from a doctor, that is the appropriate thing to do, and it may be helpful to other patients down the line.

As for suing, unless you can point to specific negligence, I don't see it, but IANAL. Talk to AL. Missing a call is not necessarily a malpractice tort, but go over the details with an attorney and see what he or she thinks.
posted by Sidhedevil at 10:52 AM on February 14, 2011 [1 favorite]

First, speak to a lawyer and decide if you have grounds/desire for a lawsuit. If you do wish to pursue legal action, don't contact the doctor except under your lawyer's direction.
But do speak to a malpractice lawyer, because if your daughter is in for increased surgery and/or rehab because the doctor was negligent, there may be grounds for the doctor or the hospital to pick up the extra expenses. Also, you don't have the expertise to know whether the doctor was negligent, so don't base your decision on whether not to sue on the statistics. (And if it was really just a matter of missing a very rare condition that could have happened to anyone, the doctor is fortunate that you are such understanding people.)

If, after consulting your lawyer/doctor/conscience, you decide not to sue, it's still appropriate report the missed diagnosis to the hospital. The doctor won't get fired (unless this is the nth of many such failures) and the knowledge gained from the mistake will help a future child.
posted by thinkingwoman at 11:03 AM on February 14, 2011 [4 favorites]

Talk to a lawyer!
posted by roomthreeseventeen at 11:13 AM on February 14, 2011

Well, if you didn't believe the first doctor, which it sounds like you didn't, why didn't you push harder or get a second opinion?

TheBones, it sounds like they did:

"Over the next 15 months my wife kept mentioning our daughter's head shape at every appointment with our GP. The GP finally agrees to set up another appointment with the same specialist."

This is making me wonder if maybe speaking to a medical board about the entire incident may not be a bad idea. Because it sounds like the GP fell down on the job a bit too, if you were repeatedly asking him "okay, are you SURE this isn't a problem? because she's not growing out of it" and the GP was brushing you off.
posted by EmpressCallipygos at 11:13 AM on February 14, 2011 [2 favorites]

Before doing anything, have you gotten a second opinion on what the neurosurgeon thinks? Not to put too fine a point on it, but surgeons are very biased towards surgery.
posted by pjaust at 11:39 AM on February 14, 2011

Response by poster: Thank you all for your responses. To answer a few questions, I only mentioned suing because everyone I tell this story to says I should sue. I don't necessarily see the value in that.

As for reporting it my thoughts are in line with Sidhedevil's, hopefully it will make this guy more careful in the future.

@EmpressCallipygos: that's my wife's opinion too.

@pjaust: we did see a second neurosurgeon at the same hospital he had the same diagnosis. And frankly, now that I know what to look for I could diagnose this with somewhere about 90% accuracy. It's really that obvious.
posted by trigger at 12:15 PM on February 14, 2011

I'm not sure I see the GP is really at any fault. Recommending you go to a specialist was the right thing to do, and unless you specifically asked for a recommendation 2-3 months later (after the first specialist was useless), I can see how the GP would assume it's taken care of. Just mentioning something is a little weird is not the same as point blank asking for a recommendation to another specialist. I can't tell quite what your wife said, but you just say she "mentioned" it frequently, and the specialist said it was common for GPs to miss it on their own.

But I might say something to the board about the first specialist. I don't know how obvious the symptoms are at 3 months, so it might be an easy mistake to make, so nothing much will come of it. I wouldn't jump right to the conclusion that you could run around diagnosing this, either. I have two cousins with something similar, if not the same thing, and the only reason they caught the second one as early as they did was because they had to take the first baby to the doctor and several specialists over a period of several months, plus surgery (at about a year, certainly not 6 months), so they already had the specialist and procedure in place when the second one came. And then the specialist *still* wasn't sure right away, even though he was looking for this one specific thing with a documented family history. It wasn't cut and dry at all, and I imagine it's even more iffy when there's no genetic history or expectations.
posted by wending my way at 2:07 PM on February 14, 2011 [2 favorites]

We had a nearly carbon copy experience - I sent a message to the email in your profile.
posted by jalexei at 2:48 PM on February 14, 2011

I wouldn't sue, mainly because you didn't seek out a second opinion and what might have been obvious later on may not have been obvious earlier on. But I don't know how the Canadian legal system or healthcare work in terms of referring people to specialists. Also, if the results at her age are still good, it doesn't seem to be that big of a deal.

Obviously you're upset, but unless there's a definite injury here (which won't be evident) you'll probably just lose money trying to sue for something that doesn't end up causing your daughter problems.
posted by anniecat at 3:22 PM on February 14, 2011

I don't think you can win by suing. Which means no lawyer is going to take the case on a contingency-fee basis, which means you're going to have to foot the bill, which means you're going to cost yourself a lot of money -- all this while his insurer defends him.

That's a complete guess, though. Talk to a lawyer specializing in malpractice.

But if it were me, I think, I would wait until the surgery, and if it was successful and all my medical bills were covered because this is Canada, I would just move on with my life.
posted by J. Wilson at 5:05 PM on February 14, 2011

I am most definitely not a lawyer, but 3 hospitals missed my best friend's broken leg after our car accident (it was hard to see on the x-ray and they were concerned with her other leg which was torn open). Her lawyer explained to her that unless she had damaged her broken leg further because of the hospital's missing the injury, she could not (successfully) sue. (You can sue someone for any reason; whether you will win or not is an entirely separate issue.) So unless you can prove that your daughter is a lot worse off now, you may not be able to sue and win. You'd have to talk to a lawyer, though.
posted by IndigoRain at 8:15 PM on February 14, 2011

It's never too late for a letter.

A letter to the docs involved expressing your disappointment would probably hit him or her in the gut. And this is what you want. You don't want the person to mount a defense, which is what happens when you sue or report someone to a professional board. They mount a defense, and if you fail to meet some official standard of evidence, they rule against you and the doc feels relief and thinks--well,my peers understand.

I think a letter expressing disappointment is in order. No need to overstate the consequences --the way you presented it here is good.

For example "I sit here on the evening of my 18 month old's surgery and have decided to write you a letter. What we understand is that tomorrow they will spend 10 hours....(fill in factual info and your emotional response here)....I am writing to you because its my understanding that you missed a simple diagnosis that would have allowed us to address this much sooner and with less risk.....I am thankful that we listened to our hearts and continued to pursue our concerns until we found the righ doctor.

And end by asking for something. Like "please take an extra moment to consider your work when dealing with your patients and their anxious parents..."

At a minimum, it gives you time to decide whether or not you want to sue. In the states, I'd use the postal option of making the recipient sign to verify that they received the letter.

Your family is in my thoughts.
posted by vitabellosi at 2:32 AM on February 15, 2011 [1 favorite]

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