In short
A claim of a wrong diagnosis is a fact of the medical record and of the expert. The complaint petition is not compensation on its own.
It is a fact of the medical record and of the expert. The complaint petition is not compensation on its own.
The request for the patient file is in a separate writing.
The date of the test is the photograph of the diagnosis claim.
Related writings: the compensation path in a public hospital.
The first practical order
- Take a copy of the discharge summary and of the test results.
- Do not mix an internal complaint of the institution with a full-remedy action or a civil case.
- A debate of the diagnosis on social media can weaken the evidence.
The current diagnosis and the need for treatment should be clarified first
A suspicion of a wrong diagnosis can form both a health worry and a loss of trust in the person. The first thing that should be done is nevertheless the safe assessment of the existing health situation, rather than debating the legal result of the previous diagnosis. If there are new or worsening signs, an application should be made to a suitable health institution, and the current test and treatment plan should not be delayed. When a second opinion is taken, the previous records should be kept. The whole of the event, and the medicines used, should be told to the new doctor without a gap.
After the current situation is determined, two separate questions should be built. Why did the first diagnosis come out different, and did this difference affect the patient's result? The first question concerns the professional standard in the diagnosis process. The second question concerns the loss and the causal link. The diagnosis changing does not give the answer to these two questions on its own. The signs of the disease may have become distinct over time, new tests may have been done, or the clinical picture may have changed after the first application.
This content is for general information. It does not present a medical diagnosis or a legal opinion particular to a person. In emergency signs, a health service should be taken directly.
Why is a different diagnosis made later not automatic fault?
In medicine the diagnosis is made by assessing the probabilities over the signs in hand, the examination findings, and the tests. Some diseases can imitate other pictures at an early stage. Some tests can come out normal at the first stage, or can gain meaning later in the course of the disease. The assessment is therefore not made by carrying the certain diagnosis known today into the past. Which information the first doctor had at the moment he or she decided, and which reasonable steps were expected with that information, are examined.
The care in the diagnosis process can be investigated under these headings:
- Were the patient's complaints and personal history listened to in a sufficient way?
- Were the warning signs that suggest an emergency or a serious disease noticed?
- Were reasonable differential diagnoses formed?
- Was a necessary and proportionate test, consultation, or referral planned?
- Were the follow-up of the results and the time of the check explained to the patient openly?
- Was a safety warning given on what would be done if the signs worsened?
The doctor is not obliged to exclude every possibility with certainty. By contrast, ignoring marked signs of risk without any ground, not following a test result, or not giving the patient a warning to return, are separate subjects of assessment. The general measures of malpractice are explained in the writing what is medical malpractice?.
How is the differential diagnosis and the clinical decision process examined?
A differential diagnosis is thinking, in a reasonable order, of the diseases that can give a similar sign. This process does not require an unlimited test for every possibility. The benefit, the risk, the cost, and the clinical necessity of the test are balanced. In the legal examination the real question is whether a reasonable health worker in the same conditions would leave the serious possibilities outside the assessment. This question is answered over the scientific standard of the relevant field of speciality.
For example, a widespread headache and a serious neurological condition can start from the same cluster of signs. Advanced imaging may not be expected in every headache. If there are certain neurological findings, a history of trauma, or an unusual start, the threshold of the examination can change. In the same way, in abdominal pain, age, the possibility of pregnancy, findings of infection, and the course of the pain affect the test decision. Without the concrete records, the result "a test was not requested, therefore there is a mistake" cannot be reached.
The ground of the clinical decision should be visible in the patient file. An incomplete record does not show that the decision was certainly wrong. It makes it harder to supervise why a certain path was chosen. The regularity of the records matters both for the patient's continuing treatment and for the reliability of the legal examination.
A wrong diagnosis, a delayed diagnosis, and a deficiency of follow-up should be separated
A wrong diagnosis can come out in the form of one disease being assessed as another disease. In a delayed diagnosis, even if the right diagnosis was made at the end, it is claimed that a reasonable period was exceeded. In a deficiency of follow-up, the first assessment may be reasonable. Not seeing the test result, not planning the check appointment, or not answering the signs of worsening forms the problem. These three headings can intersect in the same event, but their technical questions are different.
While the existence of the delay is examined over the calendar, the number of days that passed is not enough on its own. The speed of the progress of the disease, the early treatment option, and the patient's compliance with the check are taken into account. If a check was recommended to the patient on a certain date and the person did not apply without a reasonable reason, the assessment of the connection can change. By contrast, if the result was not notified to the patient, or a referral was not made despite a serious finding, the health institution's organisation obligation can come onto the agenda.
The follow-up system is not only the doctor's individual conduct. The laboratory result falling into the system, the notification of a critical result, and the chain of appointment and referral concern the organisation of the institution. The role of the private or public institution should therefore be examined in the whole of the file.
The records should be gathered in a way that will compare the two moments of diagnosis
In a claim of a wrong diagnosis, the whole of the records that extend from the start to the certain diagnosis is required, instead of a single report. The first examination note, the duration of the complaint, the physical examination, the vital findings, the test requests and the results, the originals of the images, the prescriptions, the follow-up recommendations, and the telephone notifications should be taken. The records relating to the diagnosis made at the second institution should be obtained in the same way. The information in hand during the two assessments can thus be separated from each other.
The patient can prepare his or her own timeline of the event in this order:
- The date of the first sign and of the application
- The important complaints conveyed to the health worker
- The examination made, the test, and the diagnosis given
- The medicine, the check, or the referral recommended
- The date the sign changed or worsened
- The later applications and the certain diagnosis
- The extra loss claimed to have been born in the period of delay
When this timeline is matched with the document numbers, the expert examination becomes easier. The details of how the patient file will be asked for are in the guide to requesting the patient file. Keeping the records in a safe medium, instead of sharing them on social media, is more suitable from the point of view of the privacy of health data.
The connection with the loss is assessed separately from the diagnosis error
Even if it is thought that there is a departure from the standard in the diagnosis process, the connection with the loss that came out needs to be examined for compensation. If a correct diagnosis had been made earlier, would the treatment have changed? Could the progress of the disease have been prevented? Is a heavier operation, a long hospital stay, or a lasting loss of function related to the delay? These questions are assessed over the medical probabilities and the records.
In some diseases an early diagnosis can change the result in a marked way. In others, even if the correct diagnosis had been made on the first day, the same treatment and the same result can be in question. "The diagnosis was made late" and "the delay caused the loss" are therefore not the same claim. The causal link requires an assessment that fits the field of speciality and that has a ground.
The items of material loss can rest on concrete results such as an extra treatment expense, a loss of work, a need for care, or travel expenses. A non-pecuniary effect can also come onto the agenda according to the weight of the event. A guarantee of a sum and of a result cannot be given. Keeping the documents regularly helps to show which result came out in the period of the delay of the diagnosis.
Information and the follow-up instructions are part of the file
If the diagnosis is not certain, explaining the uncertainty and the need for follow-up to the patient matters. The expression "for now there is no serious finding" should be assessed together with telling in which signs a new application will be made. The emergency warning signs, the time of the check, and how the test result will be reached should be conveyed in an understandable way. The patient's participation in the diagnosis process is not limited only to signing a form.
If an invasive procedure will be done for the purpose of diagnosis, informed consent comes onto the agenda for the risks and the options particular to that procedure. The general frame is handled in the content what is informed consent?. Consent does not mean accepting the wrong diagnosis automatically. It shows whether the patient was informed about the uncertainty and the examination that was planned.
Whether the patient complied with the recommended check can also be examined from the records. The written instructions being uncertain, the appointment system not working, or the patient not being informed, and not applying despite a clear recommendation, do not give birth to the same legal result.
The right questions should be built in the specialist and expert examination
In a wrong-diagnosis file, the single and wide question "did the doctor make a mistake?" is often not enough. The questions should be separated into periods of time. Which possibilities should have been thought of at the first application, which test was medically necessary, when should the result have been seen, and how did the delay affect the health result? This structure provides that the report rests on the concrete records, instead of a general opinion.
The file can concern more than one field of speciality. The emergency-service assessment, the radiology interpretation, the laboratory notification, and the follow-up of the relevant branch can require different specialities. It is important that the board that prepares the report is formed of specialists who fit the file, and that it sees all the records. If there are conflicting reports, the method, the data, and the ground should be compared, instead of choosing only the one that is favourable.
An objection to the expert report should not consist of not liking the result of the report. An image that was not seen, a wrong date, a question that was not answered, or a contradiction in the scientific ground should be shown concretely. While the court makes the final legal assessment, it handles the technical report together with the other evidence.
The path of application is chosen on the basis of the institution and the aim
The diagnosis process that took place in a public hospital, and a private examination or a private-hospital file, may not be subject to the same procedure. In a claim of loss arising from a public service, the compensation path in a public hospital should be taken into account for the administrative application and the administrative-court side. In private institutions, contractual liability and private-law liability can come onto the agenda. A deficiency of the institution's organisation, and the individual clinical decision, are examined separately.
The patient-rights unit, or an administrative complaint, can provide that the event is examined inside the institution. Professional supervision, a criminal investigation, and the compensation path carry different aims. The doctor-complaint process explains the basic distinctions of these paths. A general rule in the form that a compensation assessment cannot be made before the complaint result comes out cannot be built. In parallel processes, the statements relating to the same event need to be consistent.
The periods change according to the type of the application, the nature of the institution, and the way the event was learned. The dates of the event and of the document should be recorded early. One should not wait by relying on general period information on the internet. The legal frame is national for the health institutions in Ankara too. The local volume can affect only the practical pace of the process.
How is a balanced road map built?
In a suspicion of a wrong diagnosis, a sound road map consists of securing the current treatment, gathering all the records, comparing the moments of diagnosis, building the suitable expert questions, and choosing the right legal path. The order of these steps comes before claims that are strong emotionally but uncertain technically. Instead of making certain accusations open to the public about the doctor or the institution, a documented account should be used in the official process.
That it took place in Ankara or in another city does not change the essence of the diagnosis standard. The element of place can matter as regards jurisdiction, the institution, and the channel of application. The assessment of fault rests on the standard of the relevant field of medicine. The general frame of liability, of the patient's right, and of application in health law can be examined through the health-law practice area.
Not every change of diagnosis is a breach. Not every claim of a breach leads to the same legal path either. The current medical records of the concrete event, the specialist view, the nature of the institution, and the connection with the loss should be assessed together. Giving a promise of a certain result, a period, or compensation does not fit with the medical and legal uncertainties.
Where the diagnosis record is read
A claim of a wrong diagnosis is read from the record of the two moments of diagnosis and from the differential-diagnosis note. The complaint petition is not put in place of the medical record. A statistic is not written.
The office in Çankaya does not choose the authority to which the file will go.
Conclusion
This writing is for general information. The document, the period, and the procedure of the concrete event should be read separately. There is no promise of a result by rote.