Doctors should not trust patient diagnosis

Verdict: orthopedic missed important demands - man died of a heart attack

15/04/2012

Patients often come to the doctor with a self-diagnosis. Doctors should not let themselves be fooled by these self-assessments, even if they are presented confidently and with amateurish knowledge. This is a judgment of the Higher Regional Court Koblenz, which, however, is not final due to the complaint of the defendant at the Federal Court. One patient had died of a heart attack - previously no internal medical examination took place.

A scrupulous diagnosis should not be omitted by doctors by a self-diagnosis carried out by the patient, judged the Oberlandesrichter in Koblenz. An examination may not be missed even if the patient presents the possible causes confidently and convincingly, as it was called in the judgment of the OLG published on Friday. In the proceedings, a remaining wife of a deceased paramedic had complained to the doctor for damages and was now right. The man died of a heart attack five years ago.

Patient suffered from pain in the left side of the body
The then 36-year-old paramedic had complained in 2007 about severe pain in the left half of the upper body. He himself had assumed that a nerve was pinched and responsible for the left chest pain. The patient shared this assumption with a specialist orthopedic specialist. A colleague had previously brought the paramedic to the doctor's office. The patient would have told the orthopedist that „the whole thing would have been clarified with an internist“. Without further inquiries and without internal diagnostics, the physician then noted a blockage and muscle tension. Some time later, the man died as a result of a lived heart attack.

Doctor should have asked more closely
The judges ruled that the specialist obviously had failed to question more closely the development and occurrence of patient pain. According to the judges, if the orthopedist had asked for a more detailed examination, the doctor would soon have noticed that the pain of the deceased had occurred only an hour ago. An examination of the heart by an internist would not have been possible in such a short time sequence. The internal medical examination, which the patient spoke about, took place several months ago, so that a heart attack in acute pain could not be ruled out.

The defendant doctor has lodged a complaint against the judgment (file number: 5U857 / 11) with the Federal Court of Justice, which is why the judgment of the Higher Regional Court is not yet final. In the double-tracked case, however, the doctor was already sentenced to 90 days' pay for negligent homicide on the grounds of an in-depth detailed investigation. The medical approval was not withdrawn. (Sb)

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