As I recently wrote pneumonia is a deadly disease. Because of this, the diagnosis must be made promptly to give the patient the best chance of survival, particularly if the patient is in a high risk category (such as very young or very old, or has an underlying health condition that might make the effects of pneumonia worse).
As readers of this blog know, it is not enough to prove that a doctor or other health care provider was negligent in providing (or failing to provide) care. Injured patients (or if a death is involved, their family) must prove that proper care would have prevented the injury or death from occurring. This element is called “causation” – what did the malpractice cause?
Causation in pneumonia cases can be challenging for a number of reasons.
To start, the misdiagnosis cannot occur so late in the disease process to make the eventual injury or death inevitable (even with good care). Since most of these cases may be characterized as misdiagnosis cases or delays in diagnosis cases, the patient must have sufficient signs and symptoms of pneumonia to require the diagnosis be made. But on the other hand, the patient must not be so sick that, even with proper care, it likely wouldn’t have changed the outcome.
This can be complicated by the underlying cause of the pneumonia. Generally speaking, there are two major causes of pneumonia – viral and bacterial (fungi can also cause pneumonia). If the pneumonia is being caused by a bacteria, that tends to be more serious, but you can also receive antibiotics. Depending on the type of bacteria, the antibiotics can be more or less effective. For example, if a patient develops bacterial pneumonia caught in a hospital, that can be difficult to treat, because the bacteria may have developed resistance to antibiotics.
If the pneumonia is caused by a virus, often the treatment involves managing symptoms, or hospitalization for vigilant monitoring if symptoms get worse.
Proving causation in pneumonia cases can also be complicated if the patient has underlying health conditions that may have predisposed him or her to more severe consequences of pneumonia. This can include patients with compromised immune symptoms, congestive heart failure or underlying lung conditions.
Some complications in proving causation in pneumonia cases are particularly problematic, especially if the difficulty comes from factors within the patient’s control (and not the doctor’s control).
One example is smoking. If the patient is a lifelong smoker, that can make it complicated for an expert (such as a pulmonologist or critical care doctor) to conclude that earlier intervention would have made a difference. Perhaps even more important, some jurors may fault the patient him or herself for the outcome for smoking in the first place.
Similarly, if the patient had worrisome symptoms for days prior to finally seeking medical attention, the progression to that point might make it impossible for an expert to say things would have been different if the diagnosis was made at that time. And, again, some jurors may blame the patient for not seeking out medical attention earlier, when things may have turned out differently.
