Wrong Diagnosis – Whose fault? By Dr. Chika Nya-Etok

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I write a column in a newspaper titled “Your Health, Your Choice” and the following story illustrates exactly what I mean.

 

Twenty-five year old John was not feeling well at all. He had had quite a bit to drink at his elder brother’s traditional marriage ceremony two days before and developed the symptoms the next day. He knew it was just a hangover plus. But he became a little worried when he developed a fever that persisted. He decided to visit the clinic and have the doctor check if he was suffering from malaria. He had heard the jingles on the radio advising that malaria should be treated promptly within 24 hours of onset of symptoms to avoid complications that could become life-threatening. But since they also insisted that malaria should be treated using the most effective drugs, Artemisinine Combination Therapy (ACT) ONLY, AFTER CONFIRMATION by testing, he asked the doctor for the malaria test.

 

Having had consultations in the past where the doctor warned him about his frequent bouts of high alcoholic intake at parties, he was not going to tell her about the nagging abdominal pains that he had been experiencing even before the fever started. The malaria test gave a positive result and he went home with the prescribed antimalarial drugs.

 

Later that evening, the abdominal pains became excruciating and he started vomiting. He managed to endure it till morning when he was rushed into the emergency room of the hospital.

 

The doctor was genuinely perplexed. How did things get so bad, she asked John. Now he knew he had to tell the whole story because he thought he might be dying! “Doctor, I’m sorry I didn’t tell you everything when I came to the clinic yesterday. I’ve been experiencing these abdominal pains for three days now but I thought it was because of my excessive alcohol consumption at my brother’s engagement. I knew you wouldn’t approve so I left it out of my complaints. Please help me!”

 

After a thorough physical examination and laboratory investigations, a diagnosis of acute appendicitis was made and John had immediate surgery for removal of the inflamed appendix. He made a full recovery and the next week he was back on his feet and going about his business as usual.

 

So, in your opinion, whose fault was it that John was misdiagnosed with Malaria instead of Acute Appendicitis?

 

Your Health, Your Choice!

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There is a serious and urgent need to recognize that, in order to significantly improve your state of health and well-being, you must be an active participant in decision-making concerning your healthcare.

 

The doctor/nurse or other practitioner make diagnoses based on the history the patient gives them and their own clinical findings plus or minus results of laboratory and other tests. They do not function like native doctors who divine and hear from supernatural sources what the problems are by just looking at their client. Keen observation of bodily functions, clear explanation and full disclosure by a patient to the doctor are very critical to ensuring that diagnostic errors are minimized. The choices you make are just as important in seeking and applying preventive health information as they are in taking decisions about when and where to go for treatment when there are symptoms and signs of ill-health.

 

Your Health, Your Choice!

 

Dr Chika Nya-Etok is a former Country Medical Adviser of Unilever Nigeria, and is the Principal of HealthWise Concepts in Nigeria. She has been a guest expert on episodes of The HealthZone. Her passion is the dissemination of health information with a view to empowering the individual towards positive behavioral change for health promotion and disease prevention.

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