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Missed diagnosis in patient presenting with sudden onset of headache (07HDC16428)
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(07HDC16428, 18 June 2008)
Medical officer in general practice ~ Accident and medical
clinic ~ Headache ~ Stroke ~ History-taking ~ Diagnosis ~ Respect ~
Rights 1(1), 4(1)
The family of a previously fit and well 79-year-old woman
complained about the care provided by a doctor working within a
general scope of practice at an accident and medical clinic. The
woman experienced a sudden onset headache. She was taken to the
clinic and assessed by a medical officer (MO).
During the consultation the woman showed her current medications
to the MO in order to ask more questions, but he threw the
medications on the floor, telling her to forget about them as they
were not the issue. Following the assessment the MO diagnosed
frontal sinusitis and prescribed antibiotics. The patient
experienced a severe cerebral haemorrhage later that evening and
died a few weeks later.
It was held that the doctor did not take reasonable care in his
history-taking and diagnosis, breaching Right 4(1), and did not
treat the patient with respect, breaching Right 1(1). Although it
was a borderline case, a referral of the MO to the Director of
Proceedings was not warranted.
The clinic was not liable for the MO's breaches as it had
appropriate policies in place to manage presentation of sudden
onset headache, and a back-up doctor had appropriately been called
when the clinic became busy. The MO's failings were his own and
could not be attributed to the system in which he was working.
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