Liability in the context of misdiagnosis of melanoma as a plantar wart

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Full text from the Medical Journal of Australia:
Liability in the context of misdiagnosis of melanoma in Australia
Melody R Abikhair, Patrick D Mahar, Adrian R Cachia and John W Kelly
Med J Aust 2014; 200 (2): 119-121 (full text)

 

Black and white case of malpractice rather than an accident. Standard of care is to biopsy and not to treat based on an educated guess. Roll the dice and pay the price.

Steven

 

Hi Lab Guy

I pride myself on having pick up a few malignacies which other medics including in one case a dermatologist failed to spot. Are you suggesting we should biopsy all verrucae just to cover ourselves?

Nina Neal

 

Nina, my query exactly...

 

Hi Nina,

No. I do not subscribe to practicing defensive medicine nor treating the same way across the board. When you are in doubt of the diagnosis, then biopsy.

Children often have verrucae and you have seen it thousands of times, and you do not need to biopsy. Yet, if you are dealing with any skin lesion that you are not 100% confident of the diagnosis, then biopsy or the patient may be misdiagnosed. You are the specialist. It is you that needs to discern whether or not that verrucae is a bit suspicious especially on a middle age or older adult.

If we treat a verruca without a biopsy and it ends up being a malignant skin tumor, then we failed our patient and we are accountable.

I remember removing an ingrown thick mycotic nail on a geriatric patient and the nail bed appeared thicker than normal and looked a bit different. It was a bit suspicious and I excised a portion of it and sent it to Pathology. It came back as squamous cell carcinoma.

Kudos to you for picking up on the malignancies that your patients presented with.

Steven