Diagnosis is often a moving line, not a fixed point.
This case looks at what happens when an initial clinical suspicion evolves with investigation — and whether a change in diagnosis, even with a grave outcome, can amount to negligence.
When medicine recalibrates, does liability follow?
Irrefutable Facts
The patient consulted orthopedic surgeon for severe left knee pain for the past one week. The patient, in turn, was referred to a multispecialty hospital under the care of the doctor, where she underwent a series of investigations and was examined by a team of experts.
Following this, the patient was shifted to the ICU and was managed conservatively, but unfortunately, she succumbed to complications after a few days.
The doctors were sued by patient’s family. It was alleged that the patient was exhibitingthe symptoms of DVT from the very beginning. However, the doctors committed gross negligence by delaying the correct diagnosis and subsequent treatment.
It was further alleged that the initial and maintenance doses of Heparin administered was less than the accepted standards.
Doctors’ Plea
It was stated in defence that the cardiologist had suspected DVT; however, patient’s ECHO showed no significant abnormalities. It was further stated that based on the ECG, ECHO, ultrasound, and blood test reports, the patient was diagnosed with septicemia rather than DVT and was managed accordingly.
Court’s Observations
The court, upon perusing medical records and various investigation reports, observed that the patient had “infective arthritis on the left knee joint, due to which septicemia had developed.”
The court also noted that the patient was appropriately managed, and even higher antibiotics were administered. Hence, the court could not find negligence on part of the doctors either in diagnosing or providing treatment to the patient.
Prevention Is Better Than Cure
Initiating a treatment based on a provisional diagnosis and later altering it with a different final diagnosis is not per se negligence. However, appropriate efforts must be made in accordance with medical science to confirm or revise a diagnosis. The efforts and the diagnosis must be duly recorded.
Source : K. Karthiga & Ors. v/s Helios Hospital & Ors.
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