Misdiagnosis of Cyanosis and Legal Liability

Cyanosis is a condition where there is a lack of oxygen in the blood, resulting in a purple-blue color noted in the mucous membranes and the skin. In medical terms deoxyhemoglobin, non-oxygen carrying hemoglobin, is in higher concentration in the blood than oxygen rich red blood cells. There are several different causes of cyanosis including circulatory failure, asphyxiation, drug overdose, pulmonary embolism, emphysema, respiratory infections, hypothermia, sleep apnea and most types of cardiac disorders. Regardless of the cause, treatment must start immediately to avoid long term serious injury to the tissues and, in some cases, even death.

Diagnostic Procedure

Cyanosis is often confused with other health conditions or even completely missed in a cursory examination of a patient, especially if the skin color is used as the main diagnostic protocol. Diagnosis is still often done first by the purple-blue color of the skin or mucous membranes, followed by a rapid gas analysis measuring arterial PaO2 and SaO2 levels, a full complete blood count (CBC) as well as an ECG and chest X-ray.

Differential Diagnosis of Cyanosis

There are three differential diagnoses of the condition. The location of the blue-purple discoloration is key in determining the type of cyanosis present. Central cyanosis occurs with a blue discoloration around the lips, tongue and the center body core and is typically caused by heart and respiratory conditions. Peripheral cyanosis occurs when the discoloration of the skin is noted on the fingers and toes and the most distant parts of the legs and arms. Typically, peripheral cyanosis is caused by the shutdown of small blood vessels due to vasoconstriction and obstructions in the circulatory system. Differential cyanosis combines features of both central and peripheral cyanosis in some respects. The lower limbs and toes and the head are affected, but the arms and core are not.

Diagnostic Mistakes and Legal Liability

Cyanosis is often difficult to diagnose since the discoloration of the skin may be challenging to detect in typical indoor fluorescent lighting. In addition, individuals with dark skin, especially on the fingers, toes and the mouth area, are at greater risk for the condition being missed if blood gas analysis is not completed. With almost all cardiovascular and respiratory conditions and diseases potentially leading to cyanosis, medical professionals need to be vigilant to order the correct tests and rule out the diagnosis.

Medical Malpractice and Cyanosis

When medical professionals fail to respond to symptoms or test for symptoms that may be present, they may be found negligent, particularly when standards of care are not followed. When the patient suffers further injury or death from the incorrect or missed diagnosis of cyanosis, there may be grounds for a medical malpractice suit.

Working with an experienced medical malpractice attorney is the first step in reviewing your options and moving forward with a lawsuit.