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Understand medical malpractice cases by looking at the facts.
A 65-year-old woman presented to her PCP with nausea, fever, and a dark area in the visual field of her right eye. The PCP performed a physical examination but did not include a funduscopic exam. The PCP diagnosed a viral infection.
Four days later, the woman presented to an ophthalmologist with the loss of central vision in the right eye. The ophthalmologist diagnosed a retinal detachment. The surgery was unsuccessful and she now has permanent loss of vision in that eye.
Admittedly, PCPs see many patients with non-specific symptoms of nausea and fever. Most of these patients will have an acute, self-limited viral infection. However, as The Doctor’s Company points out, complaints of acute visual loss are relatively uncommon.
In the above case, the PCP failed to recognize that a dark area in the visual field is a “red flag” for retinal detachment. Funduscopic examination is a routine part of every doctor’s examination of the eye, not just the ophthalmologist’s. Why didn’t the PCP perform a funduscopic exam?
Lack of training? Maybe. More likely is the PCP concentrated on symptoms of the common viral infection to the exclusion of the unusual, but significant, visual complaint.
This could be the result of several biases: confirmation bias, rush-to-solve bias, and overconfidence bias.
Like most cases, the vast majority of patients will be lucky. The PCP’s negligence will not result in permanent injury or death. However, where the patient is permanently injured or dies, the PCP should be held accountable.
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