misdiagnosis and responsibility

[Guest guest]

Dear All,

 

I am trying to sort something out. A previous patient of mine passed away last

week, apparently the result of a series of misdiagnoses and proper treatment

that was too little, too late.

 

He came to see me 2 summers ago for severe pneumonia, which he had been

hospitalized for, for several weeks. In the following months, he very slowly

regained his strength, appetite, and weight, but had tremendous difficulty

breathing every time the weather became hot or dry. Last fall, he came to see

me again, with the same symptoms. Since the local medical community took months

to diagnose him initially, he figured he just had contracted pneumonia again.

Only this time, he quickly deteriorated, and in a couple of weeks was diagnosed

(at a better hospital he had to travel out of town for) with leukemia.

 

A bone marrow donor was found for him, but during the tests to determine whether

he was fit for the procedure and immunosuppressive drug therapy, it was

determined that the real cause of his pneumonia was valley fever. It led to the

development of a mass in his lung - surgery and healing from the surgery were

necessary before he could undergo the bone marrow transplant.

 

He did poorly after the transplant, and was put in to a medically-induced coma.

When he regained consciousness, he was diagnosed with graft vs. host disease.

He was on dialysis. Eventually, his liver failed while he was awaiting a donor

liver for transplant.

 

All along my points of contact with him, I encouraged him to seek medical

diagnosis and treatment, which he did, yet the local docs and clinics failed to

provide a proper diagnosis until too late. With my training, I had no way to

diagnose either valley fever, nor leukemia.

 

I am trying to sort out what part I played in my patient's demise, if any. I

take my responsibility for my patients' welfare seriously, and am trying to

determine whether I failed him in some way.

 

I'd appreciate any input, especially from other practitioners who have wrestled

with similar scenarios. I have had other patients die in the past, but these

were all frail elderly. This guy was only 48, and before he became ill, he was

fairly robust.

 

Thank you for your thoughts.

 

 

 

 

 

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