Misdiagnoses can have significant impacts on patient experiences and long-term outcomes, regardless of the patient’s age or condition. However, the conditions most commonly misdiagnosed in pediatric medicine differ somewhat from those that frequently appear among adult patients. The consequences of misdiagnoses in pediatric medicine are in many cases also distinct. The New Mexico medical injury team at Erin Marshall Law has experience in supporting concerned families through challenging situations regarding their children’s care. Call 505-218-9949 today to discuss your case with a knowledgeable Albuquerque attorney.
What Are the Most Common Misdiagnoses in Pediatric Medicine?
A 2022 narrative review published in the medical journal Pediatrics (”Diagnostic Error in Pediatrics: A Narrative Review,” available through PubMed) cites the results of a survey, published in 2010 in the same journal, in which mistaking viral illnesses for bacterial infections was the diagnostic error most commonly reported among physicians responding to the survey. As the authors of the 2022 article point out, however, corroborating these survey results is difficult not only because research that directly examines the incidence of misdiagnoses in pediatric medicine remains limited, but because medical research – in both published literature and study design – continues to be complicated by diverse, sometimes competing, definitions of diagnostic error.
Diagnostic Errors vs. Misdiagnoses
Outside the medical profession, it is not unusual for patients and their families to refer to any failures in the diagnostic process as “misdiagnoses.” In the context of medical discourse, however, it is common for researchers and clinicians to use distinct terminology to differentiate within the broad category of diagnostic errors.
This broad category may be divided into two important subgroups:
- Misdiagnoses: Diagnosis of a patient with a condition he or she does not have, often as a failure to recognize and appropriately diagnose the true cause of the patient’s symptoms
- Missed diagnoses: A failure to diagnose a condition that a patient does have
Missed diagnoses can co-occur with misdiagnoses when the patient does have a medical condition that demands diagnosis and treatment but the initial diagnosis is inaccurate. However, missed diagnoses can also occur when the patient is sent home undiagnosed, despite the presence of signs or symptoms consistent with at least one diagnosable condition.
Potential Role for “Overdiagnosis” in Pediatrics
The inclusion of overdiagnosis as a type of diagnostic error remains a point of contention within the medical community. Moreover, as the Pediatrics article notes, “over” diagnosis refers more accurately to the degree to which diagnoses of a condition exceed the actual frequency of that condition – that is, the tendency in clinical practice to diagnose patients with a disorder or condition when their symptoms do not fully meet the diagnostic criteria, resulting in a number of diagnoses that exceeds the true number of cases. In any one patient’s particular case, therefore, the consequence of “overdiagnosis” is likely to manifest simply as a “misdiagnosis.”
Parents may, however, wish to be aware of the possibility for over-diagnosis as relates to certain illnesses (the Pediatrics authors cite a particular subtype of hypoxemia in infants as an example) in order to remain vigilant in watching for signs that their child’s true condition is being overlooked in favor of a commonly, but perhaps erroneously, assigned diagnosis. A medical injury lawyer with Erin Marshall Law may be able to help you classify the diagnostic errors affecting your case.
Misdiagnosis vs. Malpractice
Not every misdiagnosis will qualify as an instance of malpractice, whether in pediatric medicine or in the context of healthcare for adults. Legally, malpractice cases belong to the broad area of civil torts law, in which the three main types of torts are negligence, intentional wrongs, and strict liability.
Malpractice claims on the grounds of deliberate harm are fairly unusual, while strict liability generally only applies in specific types of cases, such as certain kinds of defective product lawsuits and, depending on the state, a few other activities that do not typically involve the practice of medicine. What all of this means for patients and parents is that the vast majority of malpractice lawsuits tend to be based on claims of negligence. Misdiagnoses may qualify as malpractice if the errors can be shown to have arisen from negligence on the part of the medical professional.
Elements of Negligence
Civil trials generally require plaintiffs to prove their case by a “preponderance of the evidence,” a lesser burden of proof than the “beyond a reasonable doubt” standard required of prosecutors in criminal cases. To prove a case based on negligence, the plaintiff in a personal injury case will typically need to show that:
- The defendant owed the plaintiff a duty of care.
- The defendant breached their duty of care with respect to the plaintiff.
- The plaintiff suffered some sort of injury or harm.
- The plaintiff’s damages (injuries or harms) were the result of the defendant’s breach in their duty of care.
These four factors, known as the elements of negligence, will generally apply in any personal injury case based on an allegation of negligence tried in the American legal system. What can sometimes set medical malpractice cases apart is the standard set for duty of care in medical contexts.
Duty of Care in Pediatric Medicine
The exact wording used varies somewhat by state, but as Cornell Law School’s Legal Information Institute (LII) explains, in most personal injury cases the expectation for “duty of care” refers to the responsibility that all members of a society have to act “reasonably” in order to avoid carelessly harming others, or creating the conditions that will lead others to suffer harm. A common example of this generalized duty of care is the responsibility that all drivers on the road have to obey traffic laws and pay attention to their surroundings. Certain relationships, however, establish special parameters for the duty of care one party owes to the other.
In malpractice cases, the parameters of that duty of care are such that the duty is based not on a reasonable person’s obligation to take sensible measures to prevent harm in ordinary situations, but on the specific type of relationship that exists between a professional and their client. In medical settings, this relationship is usually between a physician or other licensed healthcare professional and their patient, and typically the healthcare provider will be considered responsible for following the medical and scientific consensus in diagnostics based on patient symptoms, as well as for applying the accepted standard of care (a different concept from duty of care) in prescribing and administering treatment.
Consequences of Misdiagnoses in Pediatric Medicine
The consequences of a misdiagnosis can vary from negligible, in the most fortunate cases, to life-threatening, in more high-risk scenarios. The range of possible threats to a child’s health can be wide, but for simplicity’s sake it often makes sense to categorize the dangers into two main groups:
- Risks of missing needed treatment
- Risks of taking unnecessary treatment
Families often want to rank these two groups in terms of their probable severity, but in reality the relative degree of risk will depend on the severity of the condition potentially going untreated due to misdiagnosis with another illness or disorder, and the probability and severity of side effects of the treatment prescribed.
In other words: There are some illnesses from which a child may recover reasonably well, even if he or she is never diagnosed and treated (many, though not all, infections can fall into this category), but there are also illnesses so grave that any time lost in getting an accurate diagnosis and beginning treatment can be costly to the child’s long-term prognosis. At the same time, there are some medications or other treatments that may pose so little risk of harm to the patient that it makes sense to begin administering them early, even while further diagnostic examinations or procedures are scheduled – but there are also medications that pose a serious threat to a child’s physical or psychological health if wrongly prescribed. If at any point you as a parent feel that your child’s health care provider may not be taking your concerns seriously, consider seeking a second opinion to help evaluate the situation.
Speak With a New Mexico Medical Injury Attorney
Misdiagnoses are a common threat in health care scenarios of all types. However, misdiagnoses and missed diagnoses alike can pose special problems in pediatric medicine, particularly when serious childhood illnesses or those that may affect a child’s long-term development are concerned. Far too many families struggle with uncertainty about how to proceed when they suspect something is not right with their child’s diagnosis. To discuss your options with a caring professional, call Erin Marshall Law at 505-218-9949 and schedule a consultation with a member of our experienced Albuquerque staff.
