Failure to refer is a recurring allegation in medical malpractice litigation, particularly against family physicians and other front-line practitioners. The claim is that a reasonable practitioner, faced with the patient’s presentation, would have referred to a specialist or for further investigation, and that the failure to do so allowed a serious condition to progress undiagnosed or untreated.
The analysis turns on what the presenting practitioner knew or ought to have recognized, and on whether the threshold for referral was met in the circumstances. The standard of care is established through expert evidence and reflects the role and setting of the practitioner involved. Causation requires the plaintiff to show that a timely referral would have changed the outcome, by leading to earlier diagnosis or treatment, which can be contested where the underlying condition carried a poor prognosis regardless.
Posts tagged Failure to Refer analyze Ontario decisions in which the failure to refer a patient to a specialist or for further investigation was in issue.
Ontario midwifery negligence case study: failure to escalate to obstetrical consultation, postpartum hemorrhage, emergency hysterectomy, infertility at 30.
The Saskatchewan Court of Appeal affirms dismissal of a failure-to-refer claim. Breach of standard of care, but causation defeated by referral wait times.
A settlement on behalf of a woman in her 60s whose family physician dismissed three years of GI symptoms despite a known family history of colon cancer.
A family physician identified a high-risk twin pregnancy and started a referral letter that was never sent. The Alberta Court of King’s Bench found liability.
A settlement involving a 65-year-old man whose ankle fracture went 40 days without orthopedic follow-up, leading to joint infection and below-knee amputation.
Paul Cahill won an $11.5 million jury verdict against an obstetrician whose failure to refer to a perinatologist caused a catastrophic cerebral palsy birth injury.
Paul Cahill settled a wrongful death claim against a family physician who failed to provide the HCC surveillance that hepatitis B carriers require.
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