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Doctors cannot trust patients to diagnose

Doctors cannot trust patients to diagnose

Verdict: Orthopedist missed important questions - man died of a heart attack

Patients often come to the doctor with a self-diagnosis. However, physicians should not be fooled by these self-assessments, even if it is presented confidently and with lay knowledge. This is a ruling by the Koblenz Higher Regional Court, which, however, is not yet final due to the defendant's complaint to the Federal Court of Justice. One patient had died of a heart attack - no internal medical examination had previously taken place.

Doctors should not refrain from doing a thorough diagnosis by self-diagnosis, as the judges in Koblenz judged. An examination must not be missed even if the patient confidently and convincingly presents the possible causes, as stated in the OLG judgment published on Friday. In the process, a remaining wife of a deceased paramedic had sued the doctor for damages and was now right. The man had died of a heart attack five years ago.

Patient suffered from pain in the left side of the body
The then 36-year-old medic had complained of severe pain in the left half of the upper body in 2007. He himself assumed that a nerve was trapped and that it was responsible for the left chest pain. The patient communicated this presumption to a treating specialist in orthopedics. A colleague had previously brought the paramedic to the doctor's office. The patient would have informed the orthopedist that "the whole thing had already been clarified with an internist". The doctor then identified a blockage and muscle tension without further questions and without internal diagnostics. Some time later, the man died of complications from a heart attack.

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

The defendant doctor has lodged a complaint with the Federal Court of Justice against the judgment (file number: 5U857 / 11), which is why the judgment of the Higher Regional Court is not yet final. In the case negotiated on two tracks, however, the doctor was already fined 90 daily rates for negligent homicide due to a detailed examination that had not taken place. However, the medical approval was not withdrawn. (sb)

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