Emergency rooms are built around recognizing symptom patterns. A patient presents with a set of symptoms, and the physician matches those symptoms to the most likely diagnosis.
The system works well when symptoms are obvious and follow a classic presentation. However, this system can result in misdiagnosis when symptoms are atypical. Reach out to our experienced misdiagnosis lawyer in Las Cruces for legal assistance.
Atypical Presentations in the ER
Atypical symptoms are symptoms that point toward a serious condition but don’t match the classic profile physicians are trained to expect.
Examples of atypical presentations include:
- A heart attack without chest pain
- A stroke without sudden facial drooping
- An appendicitis that presents as back pain rather than lower right abdominal tenderness
These presentations are well-documented in medical literature, but they still catch emergency physicians off guard.
Conditions Commonly Missed Due to Atypical Symptoms
Several life-threatening conditions present atypically often enough that emergency physicians should be watching for them:
Heart attacks
The typical presentation for a heart attack is crushing chest pain radiating down the left arm. But many patients, particularly women and diabetics, experience heart attacks through jaw pain, nausea, unexplained fatigue, shortness of breath, or upper back discomfort. ER physicians who stop considering cardiac events can miss a diagnosis with fatal consequences.
Stroke
The standard FAST screening (face, arms, speech, time) catches most strokes, but posterior circulation strokes can present with severe dizziness, vertigo, difficulty swallowing, or vision changes without the classic facial drooping or arm weakness. These patients are frequently diagnosed with an inner ear problem or anxiety and sent home.
Pulmonary embolism
A blood clot in the lungs can produce sudden chest pain and shortness of breath, but it can also present as unexplained rapid heart rate, mild chest discomfort, or a general sense that something is wrong. Pulmonary embolism is one of the most commonly missed diagnoses in emergency medicine.
Sepsis
Early sepsis often features a high fever and obvious infection. It can begin with confusion, rapid breathing, an elevated heart rate, or a drop in blood pressure. Delays in identifying sepsis can be fatal.
Appendicitis
Not every case features right lower quadrant pain. Appendicitis can produce flank pain, back pain, or abdominal discomfort that doesn’t localize typically. Patients with these presentations are sometimes diagnosed with a urinary tract infection or musculoskeletal strain and discharged without imaging.
Why Atypical Presentations Lead to Malpractice Claims
Emergency room providers owe a duty of care to patients that seek emergency medical attention. The standard of care is the legal term for how a competent doctor is expected to act in a given situation. This standard requires providers to patient’s symptoms seriously and analyze possible causes.
The standard of care doesn’t require ER physicians to catch every unusual presentation on the first evaluation. It does require them to consider serious possibilities and rule them out before settling on a mild diagnosis. When a physician dismisses a patient’s symptom without ordering the tests needed to exclude dangerous alternatives, a patient may have a malpractice claim for the resulting harm.
If you believe you suffered harm due to an ER provider’s conduct, you should consult an experienced medical malpractice attorney in Las Cruces. You could be entitled to compensation for the medical expenses required to correct the condition and money for your pain and suffering. Reach out to Coates & Johnson to schedule a free case review to learn more.