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Why there is huge rise in misdiagnosis

 A medical officer attending to a patient on a CT Scan Machine at Rift Valley Provincial General Hospital (PGH), Nakuru, on November 26, 2014. [Photo: Kipsang Joseph]

Over-reliance on equipment by doctors has been blamed for the huge rise in misdiagnosis.

The Medical Practitioners and Dentists Board has raised concerns over an emerging trend where some doctors and other medical practitioners rely more on machines instead of using skills acquired during training to treat patients.

In a report published last December, the board says the trend often leads to misdiagnosis and poor administration of treatment to patients. This, the report further notes, has contributed to an alarming rise in medical negligence litigation.

No replacement

The report concludes that machines can never replace the doctor in treating patients.

Though the board, led by its boss Daniel Yumbya, maintained that medical practice relies heavily on tools and equipment to accomplish investigations and treatment, never at any time should it replace skills.

“Computer algorithms and programmes are increasingly making decisions that used to be made by doctors,” said Dr Yumbya.

Yumbya said as technology advances “we have come to rely more on machines to carry out functions that were the preserve of humans.

“Technology can never replace clinical skills, it can only complement them,” he said.

The findings by the board were as a result of cases lodged where doctors and other medical practitioners failed to administer the correct treatment and diagnosis due to poor interpretation of results churned out by medical equipment.

In one of the cases, a woman had complained that one of her babies went missing during delivery as an earlier test – an ultrasound done at 22 weeks – had showed that she was expecting twins.

However, on delivery, only one baby was handed to her, a situation which she claimed caused her emotional trauma.

In the findings, a statement by all medical personnel in the theatre confirmed that there was just one baby.

However, two reports filed by a radiologist were not consistent as they gave different interpretation of the scans.

From the evidence, it was adduced that the patient did not actually have a twin pregnancy but a possible fibroid.

An independent ultra-sound also confirmed the same and the radiologist admitted that she interpreted the scans wrong.

“During a Caesarean section, a singleton pregnancy was found together with a large fibroid,” the board’s findings read in part.

At fault

It added: “The board found that Dr R (the radiologist not a party to this suit) was at fault for misinterpreting the ultrasound scan and misinforming both the patient and Dr B (who ordered the scans).”

In another case, a patient is said to have gone through an operation to remove a cyst that apparently did not exist.

In the case, the patient visited an unnamed hospital complaining of constipation which had been persistent for three days.

An ultrasound was ordered.

A doctor, Dr A, conducted the ultrasound and concluded that there was a cyst mass in the pelvis of the patient consistent with an ovarian cyst. The doctor recommended a review by a gynaecologist.

Dr B, the gynaecologist, is said to have seen the patient the following day and booked her immediately for a cystectomy at the hospital.

“Intraoperatively, no cyst was found and the abdomen was closed,” the board disclosed.

The board found that the hospital and the two doctors were negligent in caring for the patient while the radiologist was culpable of misinterpreting the scan.

It found the gynaecologist culpable for not providing sufficient reason for the surgery while knowing that the scan is not always diagnostic, and the hospital culpable for not ensuring standard of care.

Compensation was awarded to the patient.

The board acknowledges that there are clear cut cases where liability for defective products lies with the manufacturers, and in such cases manufacturershave been held liable.

“Less clear instances involve equipment that requires some interpretation or intervention by the practitioner. In these cases, the usual standard holds, that a medical practitioner owes a duty of care to his patients to take all due care, caution, and diligence in the treatment,” adds the board.

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