This paper examines the legal and criminal dimensions of medical misdiagnosis, using a real-world case of a five-year-old girl who died of appendicitis after a misdiagnosis to ground the discussion. It explores how negligence is defined under Black's Law Dictionary, the challenges of proving fault, and the evolving nature of evidence-based medical standards. The paper also distinguishes between unintentional diagnostic errors and willful misconduct, considers the role of patient behavior in contributing to misdiagnosis, and addresses how systemic pressures — such as physician overwork, insurance constraints, and COVID-19 — complicate accountability. The analysis ultimately weighs when negligence crosses into criminal liability.
Physicians are placed in a position of great trust as experts. This is one of the many reasons that the issue of medical misdiagnosis incites such strong public feelings regarding how the law penalizes and addresses it. Many medical diseases are so-called "great pretenders," especially in their early stages — chest pains, for example, may result from anxiety or a heart attack. In one case, a five-year-old girl with a severe stomach ache was misdiagnosed by a physician as having a viral stomach condition, only to die at home two days later of appendicitis (Doctor given warning, 2022). After examination by a medical tribunal, the physician was reprimanded for failing to consider certain critical symptoms — such as the child's lethargy — and for not performing a second examination of her abdomen. The physician was nonetheless allowed to continue practicing medicine, given that the incident was considered an aberration in an otherwise strong professional record (Doctor given warning, 2022).
The child in question was located in the United Kingdom, and had the case occurred in the United States, it is likely that the parents would have sued the physician. According to Black's Law Dictionary, negligence occurs when a professional who has a duty of care fails to act according to common prudence, given the knowledge available at the time (Pandit & Pandit, 2009). For medical misdiagnosis to constitute legal negligence, therefore, a physician would need to be shown to have disregarded conventional examination and diagnostic procedures, thereby contributing to the patient's death. However, this can be very difficult to prove.
Patients may elect not to undergo certain tests because a physician suggested them without conveying particular urgency, or because the patient is concerned about whether medical insurance will cover the costs. Who bears fault in such a situation? Similarly, a physician may make a diagnosis based on a superficial observation, without gaining a complete picture of the patient's health — sometimes because the patient unknowingly withheld symptoms that would have led to a different diagnosis. Even in the appendicitis case, the question of what precisely constitutes "lethargy" can be highly subjective.
"Changing medical standards complicate accountability"
"Distinguishing intent from negligence in physician errors"
"Overwork as a contributing factor to negligence"
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