• A wrong diagnosis of SMA syndrome and its after-effects for patient •
Case of Ms V K (My involvement from Oct 09 till now)...contd through next pages
Following is the account of V K , 20/ F who is a case of "MEDICAL MISTAKES" (IATROGENIC PROBLEMS). And all these mistakes are easily avoidable, if attention is given to standard ways of history taking, examination and doing investigations as described in the texts.
It is worth noting that this girl had faced such a misfortune in a city well-known to be an advanced city in India. At least a couple of dozen of specialists decorated with Indian, British, American, German, Australian degrees practising various specialities like medical & surgical gastro-enterology, internal medicine, psychiatry, peristalsis-logy have seen her in the past 9 years.
In her case, some of the flaws that I noticed are as follows:
• Lack in listening to the patient (forgetting that patient is telling the diagnosis).
• Not paying attention to periumbilical pain signifying mid-gut pathology.
• Not thinking of common things first. (complication of previous surgery - that happen more commonly - rather than very uncommon Wilkie's syndrome).
• Failure to demonstrate the previously handled bowel (i.e. appendicectomy site) in any of the earlier 6-7 Ba meal-FTs.
• Doing all imaging investigation during pain-free period rather than during pain.
• Un-necessary repetition of investigations to look into uncommon causes of abdominal pain.
• Failure of looking at previously operated area (IC-JN) during second surgery.
• Reluctance of various consultants to consider any differential diagnosis other than the existing "branding" of SMA syndrome or Wilkie's syndrome.
The adjacent links to further pages will take you through this girl's story chapter by chapter. I welcome reader comments. In the following pages, having (inevitably) pointed out fingers at the earlier investigators, I too may be missing out something in her case.
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