Can You Sue a Dermatologist for Diagnostic Errors?

The skin is the largest organ of the body and provides vital protection for the rest of the body. With such an important function, it is important to take care of our skin. When there are problems with the skin, a dermatologist is a doctor who can evaluate, diagnose, and treat any skin conditions. One of the most serious medical issues dermatologists deal with is skin cancer.  If a dermatologist fails to identify suspicious areas of skin cancer, it can leave the patient undiagnosed and untreated. With a delayed diagnosis, cancer can spread and the patient may suffer a lower chance of recovery. If a misdiagnosis was caused by medical malpractice, the patient may be able to recover financial compensation for their losses.  If you were misdiagnosed by a dermatologist and want to know your options, talk to your experienced medical malpractice team for legal advice. 

Dermatology and Diagnostic Errors

All doctors have some dermatology education as part of medical school and many complete a dermatology rotation during medical residency. However, dermatologists have specialized education and training specifically for conditions of the skin, hair, and nails. According to the American Board of Dermatology, there are more than 3,000 conditions of the skin, including: 

• Skin cancers
• Acne
• Alopecia areata (hair loss)
• Dermatitis
• Pemphigus
• Psoriasis
• Raynaud's phenomenon
• Rosacea
• Scleroderma
• Rashes and hives
• Eczema
• Blisters
• Moles
• Warts 
• Skin infections 
• Cysts
• Abnormal nails
• Skin discoloration
• Skin changes from aging

The right diagnosis is important because it impacts how the doctor will treat and monitor the skin disease. For example, if the doctor diagnoses a patient with a viral skin infection, the doctor may prescribe an antiviral medication. However, if the doctor diagnoses a patient with a bacterial skin infection, they may prescribe an antibiotic cream or medication. If the doctor gets the wrong diagnosis, it will fail to treat the actual condition and may expose the patient to risks and side effects of a treatment that was never necessary.  Dermatologists often use what is known as a heuristic approach to medical conditions, which uses cognitive shortcuts to arrive at an acceptable conclusion. Generally, a dermatologist looks at a patient and tries to match the image of skin diseases to the patient's disease. This is not always the most accurate approach and can lead to diagnostic errors. The dermatology community understands this problem but doctors can be reluctant to ask for feedback or second opinions.  According to a professor of dermatology, "For accuracy, we observe a skin finding that we properly categorize, then compare the visual data with our own mental database of dermatologic diagnoses. However, the notion that a dermatologist is an expert in all these steps is false, thus leading to misdiagnosis." Common skin conditions are some of the most commonly misdiagnosed, including eczema and psoriasis. However, one of the most serious skin conditions that can be misdiagnosed is skin cancer. Causes of a dermatology diagnostic error can include: 

• Misdiagnosis
• Delayed diagnosis
• Treatment errors
• Medical advice errors
• Safety advice errors
• Medication errors
• Documentation errors
• Lack of informed consent
• Communication errors
• Failure to perform a biopsy
• Cognitive errors

Skin Cancer Misdiagnosis

Skin cancer misdiagnosis is one of the most serious concerns for patients. Skin cancer is the most common type of cancer. Some skin cancers can spread quickly and metastasize, or spread to other parts of the body. Left untreated, skin cancer can cause tissue damage, scarring, and death.  According to the American Cancer Society, types of skin cancer include: 

• Basal cell skin cancer
• Squamous cell skin cancer
• Melanoma
• Merkel cell skin cancer
• Lymphoma of the skin
• Kaposi sarcoma

Early detection and diagnosis of skin cancer provide for more treatment options for patients and doctors. Patients can educate themselves on how to conduct a skin self-exam and refer any suspicious skin conditions to their doctor. If you are concerned about any skin growths, spots, or areas of the skin, talk to your doctor.  Doctors and dermatologists can often do a skin exam as part of a routine health check. People who have a high risk of cancer should get regular skin exams. People with a higher risk can include those with exposure to ultraviolet light, light-colored skin, chemical or radiation exposure, previous skin cancer, skin cancer in the family, weakened immune system, and other genetic and environmental factors. 

Melanoma Diagnostic Errors

Melanoma is not as common as other types of skin cancer but is considered one of the most serious skin cancers. Melanoma can first appear on the skin but then spread to other areas of the body. Melanoma can appear on the skin as a new dark spot or develop within an existing mole. A useful tool for self-exams is the ABCDE rule: 

• Asymmetry
• Border
• Color
• Diameter
• Evolving

A dermatologist will generally conduct a skin exam to look for any possible signs of melanoma. If there is a suspicious area, the doctor will take a tissue sample for a lab biopsy. Types of biopsy include shave, punch, excisional and incisional, and optical biopsies. Other biopsies include fine needle aspiration (FNA), surgical lymph node biopsy, and sentinel lymph node biopsy. Other diagnostic and imaging tests can also be used in the diagnosis.   If a doctor fails to recognize a suspicious area of the skin, the doctor may fail to do a biopsy or otherwise follow up with the patient. The doctor may even tell the patient that it is not suspicious, with the risk that the patient will not report other suspicious skin areas that could also be cancerous. Until the patient goes in for another exam, it allows the cancer to continue to grow and spread.  Even if the doctor does a biopsy, there could be problems with analyzing the sample. The biopsy sample may be misread. The results of the exam may not be timely communicated to the dermatologist, treating physician, or the patient, further delaying diagnosis and treatment.  Early detection and treatment have a significant impact on the size, extent, and spread of the cancer. Delays can reduce the survival rate as melanoma is likely to spread to other areas of the body. According to the American Cancer Society, the following is the 5-year survival rate for melanoma, based on how far it spreads: 

Localized	>99%
Regional	71%
Distant	32%

When a patient is diagnosed with melanoma, there are several treatment options, depending on the location of the cancer, stage, the individual patient, possible side effects, and other factors. Treatment options include: 

• Surgery
• Immunotherapy
• Targeted drug therapy
• Chemotherapy
• Radiation therapy.

It is important for patients to have a full understanding of the treatment options to decide how they want to proceed. If the doctor doesn't clearly inform the patient of all the risks, benefits, side effects, and reasonable alternatives, the patient can not make an informed decision. Lack of informed consent can be a basis for a medical malpractice lawsuit against a dermatologist. 

Medical Malpractice by Dermatologists

How does the patient know if their injuries were caused by medical malpractice? Medical malpractice is a professional negligence claim. This means the doctor did something (or failed to do something) that was unreasonable and caused harm.  A dermatologist has a duty of care to their patients to act as a reasonable medical professional under the medical standard of care. When the doctor deviates from the standards of care and it causes an injury, the dermatologist may be liable for damages. To win in a medical malpractice lawsuit, the injury victim has to prove the following: 

• The dermatologist owes a duty of care to the patient, to use the knowledge, skill, and care ordinarily used by a reasonably careful doctor.
• The dermatologist deviated from the standard of care by failing to do something that a reasonably careful doctor, or doing something that a reasonably careful doctor would not do, under similar circumstances.
• The deviation caused the patient's injuries. 
• The patient suffered harm as a result of the doctor's negligence.

In a medical malpractice lawsuit, there may be other doctors and medical professionals who may have been involved in your medical injury. In addition to the dermatologist, malpractice claims may include: 

• Internal medicine doctor
• Surgeon
• Surgical oncologist
• Medical oncologist
• Radiation oncologist
• Radiologist
• Nurse

What Does a Dermatologist Do?

In a classic episode of Seinfeld, Jerry is dating a doctor who talks about her job saving lives. Jerry becomes indignant when he learns she is a dermatologist. Jerry mocks her for being nothing but a "pimple popper." A former patient publicly thanks the doctor for saving his life from skin cancer. Jerry feels foolish for forgetting about the skin cancer screening part of dermatology.  Dermatology is a lot more than treating acne, warts, and dermatitis. According to the American Academy of Dermatology, "A dermatologist is a medical doctor who specializes in conditions that affect the skin, hair, and nails. Whether it’s rashes, wrinkles, psoriasis, or melanoma, no one understands your skin, hair, and nails better than a board-certified dermatologist."  The skin is a large organ that protects the inside of the body against outside threats, including regulating temperature, protecting against bacteria and viruses, and as an indicator of overall health. Along with the skin and hair, taking care of your skin can have an impact on your holistic health.  The primary responsibilities of most dermatologists is for diagnosing and treating skin conditions. Diagnosis is the medical process of taking all relevant information and coming up with the most likely medical condition or conditions. Treatment can include curing the condition, improving the condition, or relieving the patient of pain and discomfort.   As part of the diagnosis, dermatologists make decisions based on a physical examination, family history, medical history, medications, other medical conditions, imaging, lab analysis, and other information. Treatments can include:

• Topical medication
• Light therapy (UV)
• Chemical peels
• Laser treatments
• Surgery
• Biopsies
• Cryotherapy 
• Cosmetic injections
• Dermabrasion 

Dermatologist Education and Training

Dermatologists are doctors who undergo specialized training. In addition to 4 years of undergraduate education for a bachelor's degree, dermatologists have to go through 4 years of medical school. After medical school, training continues with a 1-year internship and 3-year residency.  Many dermatologists go on to become board-certified dermatologists. Board certification required completing the examination and training under the American Board of Dermatology, American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada. Over the course of education and residency training, dermatologists learn how to recognize and diagnose a number of skin conditions, from common to rare diseases. Dermatologists are also trained in how to do biopsies and treat skin conditions.   Some dermatologists are board-certified in subspecialties of dermatology. Subspecialty certifications include: 

• Dermatopathology
• Micrographic Dermatologic Surgery
• Pediatric Dermatology

Dermatopathology is a specialist trained in diagnosing and monitoring skin diseases, including infectious, immunologic, degenerative, and neoplastic diseases. This can involve using specialized diagnostic tools for the examination and interpretation of samples. Micrographic dermatologic surgery involves specialized training in surgery for the treatment and management of high-risk and complex skin cancers. Skin cancer removal surgery can require multiple procedures to remove all cancerous tissue and reconstructive surgery to repair the lost and damaged skin.  Pediatric dermatology is specialized training for diagnosing and treating skin conditions in adolescents, children, and infants. 

Expert Witnesses in Dermatology Malpractice Lawsuits

Most medical malpractice lawsuits require an expert witness. Medical negligence requires an understanding of medical education, practices, standards, training, and procedures. The average juror does not have the necessary education, training, and experience to know when a dermatologist did something that deviated from medical standards. This is how a dermatology medical expert can help. ,  Many states, including Maryland and Illinois, require an affidavit of merit or certificate of merit to be submitted to the court with the lawsuit. This means that a qualifying doctor or dermatologist has reviewed the case and found there is a basis for the claim.  If the case goes to trial, a medical expert will also prepare an expert report and provide expert testimony. These experts are generally other medical professionals in a similar practice area. They can review all the medical records, testimony, and evidence and decide if the doctor deviated from medical standards and if that deviation was a cause of the injuries. They can also explain their findings to the jury.  With the information, opinion, and insights of the medical experts, the jury is in a better position to decide if the dermatologist involved in the lawsuit is responsible for the patient's injuries and damages. 

How Can a Medical Malpractice Attorney Help?

A medical malpractice attorney can review your case and help you understand your legal options. Your lawyer can file a lawsuit in civil court to help you get damages for your injuries. Monetary damages can help you recover money for medical bills, future medical needs, lost income, and compensate you for your pain and suffering.  Contact experienced trial attorneys who have successfully represented medical malpractice victims and their families to recover financial compensation for injuries caused by dermatologist malpractice. Call our malpractice lawyers to find out more about your case. For a free consultation, contact Gilman & Bedigian online or at 800-529-6162.