Friday, 23 March 2012

Liverpool Care Pathway – A Fatal 'Diagnosis'

Implementation of the LCP protocols require that a diagnosis of 'dying' first be made. It is well documented that, under normal circumstances, misdiagnosis is more common than is commonly accepted to be the case. A misdiagnosis in implementation of end of life protocols such as LCP may prove fatal!

This from The State Journal Register - The Oldest Newspaper in Illinois -

Medical misdiagnoses can have fatal consequences


Published June 26, 2011 @ 6 a.m. 

Stephen Reindl told his mother what he thought would be his final goodbyes as she struggled with pneumonia and a blood infection the day after Thanksgiving.

Mary Reindl had been taken to Memorial Medical Center in late November after she broke her leg in her Taylorville home. At 78, the longtime smoker and retired state Department of Revenue employee had come to the hospital with labored breathing and abdominal bloating that was getting worse, her son said.

Doctors reviewing her case suggested Mary Reindl had fewer than 24 hours to live, and that her condition was the result of advanced lung cancer and chronic obstructive pulmonary disease, Stephen Reindl said. After he talked with Memorial staff and his mother's doctors, she was taken off oxygen, and her pain medication was increased.

"They told me there was nothing more they could do for her," said Stephen Reindl, 51. "It tore me up."

Then the case was reviewed by Dr. Thomas Shanahan, a radiation oncologist who bucked what he called "the assumption bandwagon" by Mary Reindl's other doctors and fought to treat her for a condition that had prevented her bowels from emptying.

What happened in the next days showed the potential for medical error in complex cases such as this. It also showed how one doctor's vigorous - some say abrasive - fight to counter an established course of treatment ultimately led to Mary Reindl's recovery and how questions were raised over how the doctor advocated for his patient.

Was this a case of doctors getting on "the assumption bandwagon," as Shanahan says, or was this a case in which the complexities of treatment clouded an alternative diagnosis? It's hard to know for sure, because the Springfield Clinic doctors who treated Mary Reindl wouldn't speak to The State Journal-Register.

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