Michel O, Brusis T
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität zu Köln.
HNO. 1995 May;43(5):311-7.
Claims for medical liability mostly arise when a patient believes that his sudden deafness was not accurately diagnosed, diagnosed too late or insufficiently or was not well treated. Guided by seven expert opinions potential problems in indemnity were depicted. A clear misdiagnosis of sudden hearing loss (e.g., a hearing loss taken for eustachian tube disorder) will lead to an accusation of malpractice if the doctor cannot prove an accurate otological examination and appropriate diagnostic studies. The burden of proof lies with the doctor. A further consequence of a missed diagnosis is a delay in treatment. In the literature the good prognostic factor of early treatment has been stressed but without delineating a clearcut line between "in time" and "too late". An accusation of malpractice by insufficient treatment (pills instead of infusions) has risen. Since an unequivocal treatment is not established and various modalities of therapy are still controversial, disputes could be settled more easily. The validity of "no treatment" may be considered but requires accurate diagnosis and the patient must give informed consent. Such a procedure is justifiable, even from an ethical standpoint, when the patient fully understands and agrees.