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Comment by msla | Hacker News Reader

The right answer for your son would have been for them to jump right into surgery (or whatever you Brits call it, seeing as you apparently call a doctor's office a "surgery"... the act of cutting into skin for medicinal purposes) for something which looked like a flu complicated by an ear infection. Reaching that diagnosis would likely have involved magic on the part of the MD (or whatever you call a physician) and MDs don't get their licenses from Hogwarts, not even in the UK.

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Yeah, we call the doctor's examination room a "surgery", and the place you get the actual surgery done is an "operating theatre". Divided by a common language and all that... but obviously it comes from a time when your local doctor would have performed surgery (presumably with leeches) in his front room.

But he ended up in surgery pretty quickly after we arrived at the hospital. It took them a day to analyse his X-rays and realise he was not responding to regular antibiotics, and the decision was made to transfer him to the larger hospital for the operation. As for the misdiagnosis made by our family doctor (G.P. or General Practitioner, we call them), I'm not qualified to comment on whether it was a reasonable error or not.

all doctors should be able to hear large amounts of fluid in the lungs and, furthermore, should be on the lookout for pneumonia when someone had flu and then got worse. Your doctors, in this case, performed terribly.

I suspect you are correct. The fact that the second doctor I saw immediately sent him to hospital makes me think the first doctor was not doing her job properly. I guess that's why they say you should always get a second opinion.

The second doctor shouldn't make you second guess your first doctor. The second doctor had the advantage of time. Pneumonia generally doesn't manifest in the span of hours.

Seconded. This is an insane story. You don't need a second opinion, you need a better doctor.

It's not like a liter of fluid is just dumped into the lungs immediately... couple that with Rhonchi or Rales due to (what I presume) bronchitis that WAS diagnosed. You can't treat everyone that is Flu-like symptoms as if they are going to die of pneumonia. Doesn't make sense.

but people with neck pain + fever + general sickness after a flu? that could also have been meningitis!

> our family doctor (G.P. or General Practitioner, we call them)

We have the same term and abbreviation in the US for the same people, but I never know how many people who didn't grow up around medical people know it.

> As for the misdiagnosis made by our family doctor (G.P. or General Practitioner, we call them), I'm not qualified to comment on whether it was a reasonable error or not.

Sometimes it is, and it still goes to court. I'm biased towards the US in my knowledge, but a doctor or nurse can be legitimately afraid of, essentially, the precise kind of case your son was the victim of: The extremely rare serious problem masquerading as a very common and not-very-serious problem. That road goes directly into malpractice lawsuit territory, and when you're on that road everyone goes a bit insane.

Everyone in the medical field carries malpractice insurance because, as I've implied, some malpractice lawsuits are inevitable, due to a confluence of reasonable judgement and an unreasonably uncommon malady. Does this mean malpractice law needs to be reformed (read: done away with)? No, because some people out there practicing medicine are really incompetent, or lazy, or just go a bit weird and start cutting their initials onto livers like some deranged Zorro. We need some way to get those people out of the profession.

I guess I'm not really leading anywhere with this. The fact innocent people will have to go to court over reasonable judgment which leads to a bad outcome because of blind chance is just magnifying the unfairness of the whole event, increasing it and spreading it around. Will it make the MD more likely to correctly diagnose next time? It might make them more likely to order a test that's probably not warranted statistically. That's not the same thing. Everyone's human, and humans are sometimes incompetent and malicious, so we need malpractice law, but humans sometimes make honest mistakes and always use limited evidence to reach conclusions which are sometimes wrong, so malpractice suits catch innocents and send them through a wringer.

I agree with you. This is the main reason we did not go down the malpractice route. It is far less common here in the UK than it seems to be in the US, but still fairly common. But as you said, everyone goes a bit insane. As it turned out, our doctor probably dodged a bullet because of the sheer chance that I got a second opinion and the fact that the hospital system worked flawlessly thereafter.

If, god forbid, our son had not recovered, it would have been a different story, there would have been anger to vent and likely a court case.

The difference between the UK and the US is that UK healthcare professionals have a legal duty ("Duty of Candour") to tell you when they've made a mistake; what they're going to do to fix the mistake; and what they're going to do to prevent the mistake from happening again.

This is enforced by all of the HCP registration bodies (GMC for doctors; NMC for registered nurses and midwives; HCPC for allied health professionals). It's also supported by the NHS Litigation authority (the body who'll pay out for negligence claims, or defend those in court), and various medical protection organisations (the legal organisations that represent HCPs in court cases). The MPTS (the tribunal service that holds hearings in fit-to-practice cases) also strongly recommends that HCPs apologise in full.

In England and Wales we have a bit of law ("The Compensation Act") which means an apology outside a court for something that went wrong isn't an admission of liability, which makes it a bit easier for HCPs and their employers to apologise.

I've collected a bit of information here: https://medium.com/@dan.bealecocks/advice-to-doctors-about-s...

Why should litigation be the first option for relief? This would have a chilling effect on practitioners coming forward. Taking from devops, having a blameless review would be in order to see what kind of assumptions/biases caused the poor decision and improve going forward not sue them out of practice. Sidney Dekker speaks about in the context of the aviation industry and how humane practices leads to safer flights for everyone.

It would be very psychologically difficult for someone whose relative just died to accept a "blameless review", and if that review lead to a decision that a lawsuit was unwarranted, well, that might make the relative angry enough to do something regrettable.

I agree that it's the right answer in a cold-blooded "improving the practice of medicine" sense, but laws have to take human behavior into account.

> It would be very psychologically difficult for someone whose relative just died to accept a "blameless review",

Yet that's precisely what the aeronautic industry does.

'Surgery' isn't really used - we'd normally say 'operation', as in 'grandma needs a hip operation'

Yeah, operation would normally be the noun. Surgery would still be the verb.

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