The patient and his wife were unsatisfied with the diagnosis. “Am I going to see the doctor too?” asked Mr. C.

“What about an MRI?” asked Mrs. C, “Aren’t you going to give him one of those?”

“I’m going to go discuss the case with the doctor, and she can decide whether she thinks it’s necessary to examine Mr. C or order any further tests,” said Mr. P.

He stepped out of the room and caught Dr. L right before she walked into another exam room to see her own patient. Mr. P quickly described Mr. C’s symptoms, the results of the examination, and his diagnosis of muscle strain. Dr. L agreed with the diagnosis, declined to examine Mr. C, and then excused herself to meet with her patient.

Mr. P returned to Mr. and Mrs. C. “I spoke to Dr. L and explained your situation. The doctor agrees with my diagnosis that it is a muscle strain,” said Mr. P. “Go home and rest, and I’m sure you’ll find that the pain will improve over the next few days.”

“But what about the MRI?” demanded Mrs. C. “I want my husband to have one. And I want him to have a better painkiller than ibuprofen. Aren’t you going to write him a prescription?”

“I’m sorry,” he told Mrs. C, in what he hoped was a kind but firm tone, “an MRI is not necessary. Your husband has a muscle strain and just needs rest. Feel free to call me if he doesn’t improve,” he said, ushering the patient and his wife out of the exam room and to the door.

Mr. C went home to rest, but he did not improve. Two days later he was taken to the emergency department again, where he was admitted to the hospital with symptoms of septic shock and multi-organ failure due to an undiagnosed infection of the psoas. In less then two weeks, Mr. C died.

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Legal Background

After the death of her husband, Mrs. C sought the counsel of a medical malpractice attorney. The attorney hired a medical expert to look at the records, and then he asked the expert whether an infection of psoas could have been diagnosed and treated in this case.

“Oh yes,” said the expert physician. “If Mr. C had been given an MRI or CT scan, the infection would have shown up. It could have been treated with a broad-spectrum antibiotic and by draining the abscess. Increasing pain is not consistent with a diagnosis of muscle strain – the clinicians should have known this.”

The attorney took the case and sued Mr. P, Dr. L, and the clinic.