Description
Discuss the appropriate differential diagnoses for this patient.
The patient Mr. Shien complained of left calf swelling and pain behind the knee. He also verbalized that the pain makes him unable to move around. A very important to include in the differential diagnosis is deep vein thrombosis. Deep vein thrombosis signs and symptoms include swelling, pain, tenderness, and redness of the skin (Centers for Disease Control and Prevention, n.d.-b).
A ruptured popliteal cyst or Baker’s cyst could also be one of the patient’s differentials as the patient is reporting pain behind the knee which can be ruled out with an MRI, X-ray, or ultrasound (American Academy of Orthopedic Surgeons, n.d.).
Leg cellulitis could also be one of the patient’s differential diagnoses. The patient was having pain and swelling in his leg and to rule out the diagnosis by extensive physical assessment. The presence of chills, fever, warm, and tender-to-touch skin on the leg could indicate an infection (Centers for Disease Control and Prevention, n.d.-a).
Is the provider legally liable to explain to the patient the diagnostics that they are ordering? Why?
A provider is legally liable to explain to the patient any treatment, procedures, or services provided or ordered for them. If the patient had been informed beforehand of the purpose of the ultrasound to be performed on him, he would have requested the provider to order the procedure and timely treatment could have been rendered. A part of informed consent is shared decision-making which allows the patients to participate in making healthcare decisions (American Cancer Society, n.d.). Shared decision-making is about the collaboration of the provider and the patient in developing a plan of care affecting the patient’s health, and they can both collaborate in choosing treatment, tests, or procedures (American Cancer Society, n.d.).
How many missed opportunities did Esteban have?
Esteban had three missed opportunities that could have saved Mr. Shien’s life. The first one is when the patient first comes to the office, his differential diagnosis should include deep vein thrombosis and be ruled out with a leg ultrasound right away. The second one is when the patient came back three weeks later to report his left calf swelling and pain, the ultrasound could have been done immediately but rather the ultrasound was scheduled the next day if the procedure was done the same day or if Esteban sent the patient right away to Urgent care or Emergency care services the patient could have been saved. The third time is when the procedure was scheduled for the next day, and there was no urgency with the situation and when the result came, the patient already suffered from complications of deep vein thrombosis which is pulmonary embolism.
Should Esteban be sued? Why or why not?
Esteban and his practice should be sued because it is medical malpractice. There are many instances that which Esteban missed the opportunity to diagnose and rule out deep vein thrombosis on the patient’s condition but rather despite the provider knowing that it could be a possibility he still did not rule out the diagnosis which led to the patient’s death.
References:
American Academy of Orthopedic Surgeons. (n.d.). Baker’s cyst (Popliteal Cyst). https://orthoinfo.aaos.org/en/diseases–conditions…
American Cancer Society. (n.d.). What is informed consent? https://www.cancer.org/cancer/managing-cancer/making-treatment-decisions/informed-consent/what-is-informed-consent.html
Centers for Disease Control and Prevention. (n.d.-a). Cellulitis. https://www.cdc.gov/groupastrep/diseases-public/Cellulitis.html#:~:text=Cellulitis%20is%20a%20common%20bacterial,and%20cause%20serious%20health%20problems.
Centers for Disease Control and Prevention. (n.d.-b). Venous thromboembolism: Know the risks, signs, and symptoms. https://www.cdc.gov/ncbddd/dvt/infographic-risk.ht..
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