In healthcare, a prompt and accurate diagnosis is not just a clinical expectation, but also a legal requirement. When healthcare practitioners fail to diagnose a condition promptly, accurately or at all, patients can suffer devastating consequences that impact them physically, emotionally and financially. This article explores the legal implications of a healthcare practitioner’s failure to diagnose, and the legal recourse available to affected patients.

What is a failure to diagnose?

A failure to diagnose occurs when a healthcare practitioner fails to identify a condition or disease in a patient within a reasonable time and with the reasonable degree of investigation expected, despite the presence of signs and symptoms that warrant further investigation. This can happen for various reasons, such as failing to order critical diagnostic tests that could reveal the underlying condition, misinterpreting test results, or overlooking, dismissing or ignoring symptoms that could be early indicators of a particular illness.

In many instances, a timely diagnosis can be the difference between a full recovery and the onset of long-term complications or, in worse cases, the passing away of a patient. When diagnosis is delayed, critical time and opportunities for early intervention is lost. This exacerbates the patient’s condition, increases the risk of severe health deterioration and results in additional and higher costs for treatment, loss of income and emotional distress.

 Medical negligence and malpractice

Healthcare practitioners are but only human and are capable of error. As such, not every diagnostic error made by a healthcare practitioner constitutes negligence or malpractice. However, the law places a standard of care that all healthcare practitioners need to adhere to when treating and diagnosing patients. It is therefore important to outline when a failure to diagnose will constitute medical negligence or medical malpractice.

Medical negligence is distinguishable from medical malpractice. On the one hand, medical negligence occurs when a healthcare practitioner fails to perform their duties with the degree of skill and care reasonably expected from a competent healthcare practitioner of the same field, and thereby causing harm that was foreseeable and preventable to the patient. Medical malpractice on the other hand extends beyond mere negligence to include intentional wrongful acts, omissions or severe misconduct by a medical practitioner.

As such, to establish that a failure to diagnose constitutes either negligence or malpractice, it must be proven that the healthcare practitioner deviated from the expected standard of care, that this deviation directly caused harm to the patient, and that such harm was both foreseeable and preventable. In cases of malpractice, evidence of intentionality or gross recklessness is also required.

Legal recourse for affected patients

Whether due to medical negligence or medical malpractice, patients affected by a healthcare practitioner’s failure to diagnose have the right to seek legal recourse against the legal practitioner in question or against the State in cases involving healthcare practitioners employed by the State. Affected patients may claim for compensation for damages under the following categories:

Medical expense – When a healthcare practitioner fails to diagnose a condition timeously, a patient may require more extensive treatment than they would have otherwise needed. In such cases, the patient can claim for past and future medical expenses.

Loss of income and earning capacity – If the healthcare practitioner’s failure to diagnose results in a permanent or temporary disability and/or an inability for the patient to continue with their current work, the patient may claim for any income lost during recovery, and any future income lost as a result of a diminished earning capacity.

General damages – A failure to diagnose often means a patient will endure unnecessary pain or psychological distress due to the progression of an untreated illness. As such, affected patients may claim damages for pain and suffering, loss of amenities of life, permanent or temporary disability, and emotional and psychological trauma and distress.

Loss of support – In tragic cases where a healthcare practitioner’s failure to diagnose results in death, the deceased patient’s family (dependants) may institute claim for the loss of financial support from the deceased and the funeral expenses incurred in burying the deceased.

A failure to diagnose is not just a clinical oversight, it is also a significant legal issue that can have devastating consequence for patients and their families. Whether due to negligence or malpractice, South African law provides victims with the right to claim compensation for the damages suffered as a result of the medical practitioner’s failure. Pursuing such claims requires strong evidence, expert medical opinions, and legal guidance.

Legal Implications of Failure To Diagnose