Incompetent Doctor

[Damselfish]

Hi,

4 years ago I had Legionnaires Disease. It took 3 months for my doctor to diagnose this and only after I kept badgering her to send me to a specialist as I wasn't getting better. So, in the end I received no treatment and have had ongoing health problems ever since. If I had been properly diagnosed and treated correctly I would have been well in a few weeks and all over. Instead I was off work at the time for 9 months, developed hypo-thyroidism, low adrenal reserve, M.E., fibromyalgia and viral arthritis. Can I sue her?

 

Thanks

DF

[mree]

The first thing you need to do is get a documented medical opinion of your condition and it's causes. This is called a medical report (sorry if that's obvious) and would probably need to be done privately. You would then contact a solicitor for a legal opinion of whether you've got a case after the report has established the cause of your conditions.

[arthurdent]

be thankful they did eventually diagnose something...

 

I went into Lewisham hospital with a horrendous hand condition a number of years ago...queueing up for a while in A+E - it wasn't very gratifying to hear the emergency doctor claim....

 

"we even checked the 'internet' Mr *******, and we couldn't find anything!".

 

If doctors are openly using 'google' searches to solve our health problems we should probably start worrying folks.

[emmaf01]

Does sound like a very "Arthur Dent" type of thing to happen though!

 

I've had a skin condition for 11 years which has never been properly diagnosed- I've been given different diagnoses everytime a doctor has looked at it. Painful, irritating and stops me walking sometimes(its on the soles of my feet). I've given up, and just try to live with it.

 

But that isn't incompetence- unlike missing a serious illness, like Legionnaires.

[Panthro]

Double Post

[Panthro]

Sorry but how do you know you would be totally cured and suffer no long-lasting ill effects. Legionnaires can cause a whole host of problems even with quick diagnosis and treatment. You may be able to raise a complaint against the GP for a slow diagnosis, but I doubt you would be successful in a claim.

 

BTW, What's the difference between using a book and the internet. The internet is more up to date and I would think they would use reputable sites to query diagnoses. I as a nurse routinely use the internet, for example to check the BNF, EMC, or Medusa.

[DonnyG]

I don't think it's very fair to take this out on your Doctor. Remember their job is to help you. Hindsight is a wonderful thing and can be easy to say now that if X happened Y wouldn't of happened. Doctor's (yes my OH is one) work very hard and are very dedicated to doing their best.

[DonnyG]

be thankful they did eventually diagnose something...

 

I went into Lewisham hospital with a horrendous hand condition a number of years ago...queueing up for a while in A+E - it wasn't very gratifying to hear the emergency doctor claim....

 

"we even checked the 'internet' Mr *******, and we couldn't find anything!".

 

If doctors are openly using 'google' searches to solve our health problems we should probably start worrying folks.

 

Google is a great resource!

[Damselfish]

There are many doctors out there who work very hard and are very diligent at what they do. However, there are also a large number of doctors which treat one symptom at a time, never thinking to link them together and are pretty hopeless. I have now left the incompetent doctor and moved to a competent doctor! The incompetent doctor I now know has a very long history of mis-diagnosis and has caused several people I know to be rushed to hospital through not correctly diagnosing simple problems. I hear what you are saying DonnyG and I am sure your OH is a very good doctor, but bad ones exist too and unfortunately they are in a position to do a lot of damage.

[bally35]

Doctors do use the internet, especially in cases where the condition is rare and they have access to sites that you and I dont have.

My daughter has a rare genetic syndrome, what really gets me is that her paefiatric consultant didnt bother his backend to follow the established protocols for her particular syndrome , whcih has s erious implications.

Apparently and according to him when questioned " ultrasopund has never been proven at being successful at diagnosing tumours"

He also put this in writing.........................

I eventaully got a wriiten apology for the 14 points of compalint that I had made.

Daughter has until she is 21 to sue, if she so wishes

[DonnyG]

There are many doctors out there who work very hard and are very diligent at what they do. However, there are also a large number of doctors which treat one symptom at a time, never thinking to link them together and are pretty hopeless. I have now left the incompetent doctor and moved to a competent doctor! The incompetent doctor I now know has a very long history of mis-diagnosis and has caused several people I know to be rushed to hospital through not correctly diagnosing simple problems. I hear what you are saying DonnyG and I am sure your OH is a very good doctor, but bad ones exist too and unfortunately they are in a position to do a lot of damage.

 

Yes, of course.

[mazzab]

be thankful they did eventually diagnose something...

 

I went into Lewisham hospital with a horrendous hand condition a number of years ago...queueing up for a while in A+E - it wasn't very gratifying to hear the emergency doctor claim....

 

"we even checked the 'internet' Mr *******, and we couldn't find anything!".

 

If doctors are openly using 'google' searches to solve our health problems we should probably start worrying folks.

 

I am a GP and I often check information on various quality websites such as GP notebook, eMedicine etc. My brain is only so big and medicine is a huge field. The internet is a huge easily accesible and redilyt searched textbook. What would be bad is a doctor who knew they didn't know and then did nothing to remedy their lack of knowledge in a manner that then affected the patient's care. The real trick is to "know what you don't know" (concious vs unconcious ignorance!) which is harder than you might think at first!

 

I will often come accross something I have not seen for a while - yesterday I saw someone who might have had malaria, which I last saw 8 years ago - so I look it up. I would be reassured by a doctor who did that - he is making sure he does the safe and correct thing - and I'm puzzled that some patients just expect us to know everything about everything.

 

Looking at the rest of this thread I can sympathise with Damselfish - Legionnaire's is an unpleasant disease. I know from experience it can be hard to diagnose, but three months seems a very long time. To sue successfully you have to show that your doctor fell below a "reasonable standard of care" - ie that most concientious doctors would have done a lot better. You also have to prove that the consequences were caused by the lapse of care - this is where most cases fail. Lets look at what you tell us - you can PM me with details if i make assumptions that are wrong.

 

As a GP my practice is to think about "atypical" pneumonias in people who are taking more than 2-3 weeks to get better after respiritory infections and febrile (feverish) illnesses, but it can take a month of looking hard to find some even then. I can only do this if the patient comes back to tell me they are not getting better. I tell them to come back after 2 weeks if still ill, earlier if worsening. I would not be suprised to take 6-8 weeks to confirm and treat a milder (ie not life threatening) case of legionella. I suspect we sometimes successfully treat them without knowing simply by using "second line" antibiotics.

 

You don't tell us how often you saw your GP. If it was less than 3 times then it is hard for any GP to know that things are not going to plan if you don't come back, however if you don't come back because a clear plan of when and why to return is not given, then that is bad practice by the GP.

 

You don't say whether the Gp did any tests - blood tests, a chest x-ray, sputum or urine tests etc. If they did these in the first 4 weeks it would be difficult to show they were negligent as it would show they were looking for unusual causes.

 

Finally on this first part of the case (negligence) you do not say who actually made the diagnosis and how you were treated. This may be relevant as to who was negligent.

 

On the second point - "Causation" in legal terms - I suspect you will have more of a struggle. The problems you cite are not listed in my textbooks or on several good websites as recognised complications of legionnaires. Hypothyroidism in particular may have been a cause of all the others, and even left you susceptible to the legionnaires in the first place. It is also fair to say that diagnosing and treating you earlier may have made no difference to these problems.

 

Many doctors would also want to look at whether you are now focussed on a so called "sick role" and identify yourself as a sick person thus keeping you feeling unwell more than if you were to put it all behind you and concentrate on other things - they may try to argue this in court which could be very upsetting for you. Fibromyalgia, M.E, viral arthritis and low adrenal reserve are poorly defined, poorly understood syndromes which have complex causes and a large psychological component. Proving any act of negligence caused such conditions is difficult but not impossible.

 

In summary I think you may be a victim of medical negligence, although you may just be a victim of bad luck - inconclusive tests etc., but I suspect you would find it hard to win a case for the things you think were caused by that negligence. You would have an easier ride in the states where "causation" is not such a large hurdle. Under UK law BOTH hurdles must be cleared to win a case. I would proceed only with expert advice.

 

Hope this helps you decide.

[Damselfish]

Hi mazzab,Thank you for that very in depth response. To be honest I don't intend to try and sue my old GP, I'm very busy and don't find the prospect inspiring. I do find it tragic that so many GPs do get away with negligence, whilst I also appreciate that there are thousands who are very good. I was just interested to know whether they had been negligent, as this is how it appeared to me.In answer to your questions, I will try and take them in order:I saw my GP every week, for the first two months, as I kept getting worse. She did do some tests, but they were actually all for viral itests, and she never ran a bacterial check. She did put me on random courses of antibiotics but not the right ones for legionella. My GP kept trying to put me on Prozac, because clearly I was depressed!!! Talk about adding insult to injury, of course I was a little down I had been ill for weeks, the doctor seemed to think it was all in my head and I felt like death!!! I did not go on Prozac!!! I only got diagnosed when I pushed to go and see a specialist. She sent me to a consultant general practitioner who did the right test, first visit, and came back to me with the results. He said that as I had survived so far I would probably live!! Comforting.I do suspect that I have had problems with my thyroid and adrenal glands for years. I am treating these and am getting better - not through my G.P. I hasten to add, who would rather still give me Prozac!! This all in the mind thing I have to say seems to come more from Doctors who don't understand than the people who live with chronic conditions. I do appreciate that sometimes sufferers of chronic conditions can get depressed, which is very hard, but this label of 'sick person' can only be applied by somebody else and I would refuse to be labeled such. It is a very insulting concept to all sufferers of chronic conditions, and one I think doctors sometimes use to alleviate the pressure off themselves. I.e. It's ok that person is just mentally committed to being sick and therefore I cannot help them!!!! I guess there may be times when people are hooked on being sick, but this surely means that there are bigger problems elsewhere? Attention seekers, usually need attention!!

[bally35]

"Many doctors would also want to look at whether you are now focussed on a so called "sick role" and identify yourself as a sick person thus keeping you feeling unwell more than if you were to put it all behind you and concentrate on other things - they may try to argue this in court which could be very upsetting for you"

 

Would that be like the doctor who argued that he did not inform me that my daugter had high risk of tumours, becuse he did not want to upset me, or the fact as that as a paediatrician he was not experienced enough in the field of genetics and did not make a referral. (which I believe under GMC guidelines , he had a duty to do)

I also further belive that you are not allowed to criticise a fellow doctors care or ability.

I have often found that many doctors are arrogant enough to belive that if something is outside their realm of knowlege that they dismiss the patient, which unfortuantely came across at the end of your post.

( By the way one brother studying medicine, two brother-in-laws who are doctors, so understand that you are taught arrogance).

I have had to get in touch with the person who "discovered" my child syndrome, and when there have been doubts over her care, it is he who guides the doctors via e-mail.

Or the GP, who when I voiced concerns over my mother-in laws failing health was nasty and said "Shes just a bit depressed since the death of her husband.I will not speak to you about this"

He then hung up on me .Two weeks later the lady in question collapsed with respiratory distress.She had Motor Neurone disease, AND DIED A FEW MONTHS LATER.

I had been begging him to do something for 18 months and in one private referral said "I believe that there has already been too much concern about this patient"

So tell me how subtle are the effects of Motor Neurone disease to the point of someones breathing being the last function affected?

Thats how difficult it is to get care.

[johnhill007]

I had a similar mis-diagnosis on a back complaint and ended up suing and winning against the NHS for £ 1/4m (they settled earlier this year).

 

As part of our building and contents insurance we had legal cover thrown in - it was this through this cover that my concerns were passed onto solicitors who establised I had better than 50% chance of winning the claim - so they handled the claim at no cost to myself - and won (after 3 years).

 

It may be worth while initially checking policy documents to see if you have such cover in place - the cost of going it alone could be quite tough (medical reports, examinations, etc, etc).

 

Hope this is of some help.

[emmaf01]

Well done john!!!!

[Monty2007]

Hi,

4 years ago I had Legionnaires Disease. It took 3 months for my doctor to diagnose this and only after I kept badgering her to send me to a specialist as I wasn't getting better. So, in the end I received no treatment and have had ongoing health problems ever since. If I had been properly diagnosed and treated correctly I would have been well in a few weeks and all over. Instead I was off work at the time for 9 months, developed hypo-thyroidism, low adrenal reserve, M.E., fibromyalgia and viral arthritis. Can I sue her?

 

Thanks

DF

 

I think you have a good case but need expert legal advice and quickly. My brother had throat cancer and for 6 months the doctor just prescribed antibiotics and told him to gargle with TCP. He then had major breathing problems (only 50) but fortunately for him he was in Newcastle and was rushed into hospital and then to their oncology unit, diagnosed with throat cancer and survived. He sued his GP and the settled out of court for £300 K. Not much really since he cannot work again and they did not admit liability.

 

He had a good lawyer, it took two years which is quick in such cases.

 

Good luck.

[trixter444]

A friend of mine has successfully sued her local hospital! She fell out of bed and hurt her arm, went to see her GP who told her she had possibly sprained it or fractured it so he sent her to our local hospital's A&E, where they did some tests, no xrays were done I might add though!! Only to be sent home telling her to rest it, 2 weeks later her fingertips and arm were turning blue, so her husband rushed her to A&E again, to be sent home again!! (yes it gets worse!) to wait another week where she was very unwell, ended up back at the hospital where they finally did an xray to be told she had fractured her arm, found out she had a blood clot and had to amputate from the elbow down. She got 1.5million for loss of limb by negligence.

[mazzab]

Hi Damselfish,

 

Thanks for your detailed reply to my first post. I think you would have a good chance of showing negligence on the part of a GP who saw someone with respiritory symptoms 6 times and didn't check for atypical pneumonia or order a chest x-ray. I think your GP sounds negligent and possibly a bit lazy!

 

I'm glad to hear you are getting better and making progress with treating these problems.

 

I appreciate your comment on the preexisting symptoms relating to thyroid / adrenal disease - Unfortunately I suspect that these would scupper your chances of proving causation for the bulk of your symptoms, and so your chances of any real payout, but I'm not a medicolegal lawyer so you could take advice if you change your mind about legal action. My comments about causation are important as this is where most medicolegal cases fail, not on the proof of negligence. Just because the doctor did something "bad" does not mean you will get a payoff. There has to be a clear negative consequence of the negligent action caused largely or solely by that action. I'm not sure you would be able to prove this " on the balance of probabilities", but your legal advisors may see this differently.

 

If you look at the comments about succesful cases posted above you can see that the disability or problems caused by the negligence are clearly and demonstrably linked to the negligent act - ie they can show that a timely diagnosis or better plan of management would have averted those consequences. This is where I suspect you may struggle.

 

Both you and Bally35 have picked up on the comment I made about the so called "sick role" and I fear I may have upset you both with it's use, which was not my intent. Medicolegal lawyers and expert witnesses will often drag this concept in to trials and cause much upset and offence, so I was hoping to warn you of that possibility before you commenced legal action.

 

The concept is overapplied by doctors and lawyers, and sounds very uncaring, but it is not invalid - I suspect most doctors have seen people get better suprisingly quickly once they no longer had anything to gain by remaining ill - some patients are suprised by it too! I don't think this is usually concious malingering (although it sometimes can be!), but all illness has a psychosocial component, often subconcious and at odds with our concious desire to get well. To neglect the psychosocial aspect of chronic illness is to miss the chance to treat one of the major causes of that illness and so do your patient a disservice. This is not arrogance but practical and holistic medicine.

 

I was not applying it to you, Damselfish - It is an issue that I would only raise with patients I knew well from face to face contact - but others may. I don't think it is helpful or sensible to hope that they will not, and I think people should be prepared for this as lawyers fight dirty.

 

Bally35: I dont agree that we are taught arrogance at medical school, but I do agree that there are arrogant doctors, (just as there are arrogant lawyers, bankers, hairdressers, footballers, or if you like just arrogant people), and if they are used as role models then I suppose this perpetuates the behaviour - it's a line you walk between apparent confidence (like not checking information in front of the patient to preserve your aura of omniscience, but checking it later in private), and foolhardy bravado (like not checking at all). Medicine is full of uncertainty and many decisions are not 99% certain but 55% on to 45% against. The trick is to manage that uncertainty whilst maintaining the confidence of your patients who look upon your lack of certainty in different ways - some are pleased to be involved in sharing the uncertainty, but many are not. Telling which patients are which is really quite hard, even when trying conciously to do so. Get this wrong and you will seem indescisive, or arrogant. I would hope that re-reading my opening sentences about using the internet during a consultation would show that I am not afraid to show my humility and lack of omniscience in front of my patients!

 

Witholding information is another moral minefield, and one where it is easy to do the wrong thing, as breaking bad news is difficult and upsetting for both patient and doctor. I tend to err on the side of disclosure in situations like Bally35's (I am, after all, a Yorkshireman!), but I have upset patients (rarely), and relatives (more often) with this policy, so It is rarely clear cut. Older generations of doctors are more likely to conceal unpleasant facts, and I think the tendency is to share bad news more than we used to exactly because of cases like yours. I'm not sure that is much to do with the concept of the sick role, but it is still an important area to discuss frankly and openly, and its very helpful to hear the views from the patients side of the fence from a case where I am not personally involved and so not on the defensive!

 

My intention on replying to posts in this forum is to offer impartial advice to people who feel let down by their own doctors. I'm not sticking up for bad doctors - check out other posts of mine and you will see I am critical of clear bad medicine. I hope to show sometimes that bad decisions may be made for good reasons, (often clearer in hindsight), but usually to help people resolve their problems, and also to explain things better - many doctors are very poor communicators or don't use the communication skills they do possess often enough (which IS arrogant, I agree!).

 

So In summary, I hope this was helpful to you both, and I hope things continue to improve. Please do not be offended by what is meant to be a frank discussion of some complex moral and clinical issues, but remember these are my opinions and I'm a doctor not a lawyer. My views do not represent those of any organisation or professional body.

 

Please click my scales if you find this helpful (at least on the balance of probabilities......)