A doctor's duty to make a correct diagnosis requires him to inform himself by ordering the necessary tests, interpreting the test results correctly, and arriving at a logical conclusion by putting all the pieces of the diagnostic picture in their pro

per places and perspectives. With the sophisticated diagnostic tools today, a wrong diagnosis is more often the result of negligent or careless diagnostic work-up than lack of medical knowledge. It is often impossible to make a precise diagnosis, but there is rarely an excuse for making a wrong diagnosis. The following are some of the most common negligent errors:

1. Failure to do all routine screening tests indicated by the patient's history or physical findings.

2. Ignoring test results which do not fit in with the doctor's preconceived idea of what is wrong with the patient, especially when those results are positive.

3. Failure to repeat laboratory tests periodically or if the patient's condition does not respond as expected.

4. Attributing the patient's illness to a previous disease without checking to learn whether or not a new condition has developed.

5. Reliance on negative laboratory results, which do not square with other test results or the patient's general condition, especially if the patient's condition continues to decline.

6. Failure to repeat physical examinations and laboratory tests at frequent intervals during the course of a long illness.

In a Florida case, a 50 year-old man, with a history of smoking, went to a doctor complaining of wheezing and pain in the c

hest, a clinical picture suggestive of lung cancer. Even though the doctor was a specialist in Internal Medicine, he treated the patient and failed to take a chest x-ray for almost a year. When another doctor finally ordered a chest x-ray, the man's lung cancer was inoperable.

In a Georgia case, an elderly man in a nursing home complained of passing blood in his urine. This is a cardinal sign of cancer of the urinary tract and demands an immediate and complete work-up to identify the cause. However, the nursing home doctor did nothing about it for over a year, even though the bleeding was repeatedly noted in his chart, and the nursing home staff did nothing to notify the man's family or any other doctor. When his family finally found out and took him to a urologist, he was found to have terminal kidney cancer and died within a few weeks.

Now that you know what constitutes medical malpractice or dental malpractice, you can decide whether your doctor actually committed a departure from good and accepted practice that caused your bad results and is grounds for a malpractice lawsuit. Do not think about the words malpractice or negligence, which carry a moral implication of wrongdoing. Think about a departure from good and accepted practice. Did the doctor or the hospital employee do something that was not in keeping with accepted practices by good doctors? Did he make a serious mistake that a good and careful doctor should not have made?

The Rule Is: A valid medical malpractice case or dental malpractice case should be based upon a showing that the doctor did something that a good and careful doctor, in the same or similar situation, under the same or similar circumstances, would not have done.