Hospital: No =?UTF-8?Q?=E2=80=98misdiagnosis=E2=80=99_?=by fired Saints doctors - The Washington Post

HM Epstein hmepstein at GMAIL.COM
Wed Aug 23 13:19:42 UTC 2017

​OK, folks and sports fans. This goes to the heart of
​the key research question, "W
hat is diagnostic error?

A player is injured on the field, the team docs diagnose it as a bone
bruise meaning he can return to play during the season. However, he goes
for a second opinion and discovers he has a fibula fracture which requires
surgery. He will miss
​four to seven weeks
 of the season.

The hospital backs the doctors saying this is the normal process of Dx.

But wait, this article is missing two facts found in earlier articles.

One, the team docs knew that "the Saints were frustrated with Breaux's
history of nagging injuries that they felt he could have played through."
Does that add to cognitive bias? Or to pressure the docs may have felt from
team management to "patch and play"?
​ Or something else?​

​Two, ​
just to complicate matters, Breaux was "derailed" in the previous season by
a broken fibula. One last piece of information
​ about it​
: "the
​[new] ​
fracture is right below where Breaux had a plate inserted to repair the
same fibula that forced him to miss seven weeks last season."
​So, in your opinion:

   - ​I
   s this diagnostic error or is the hospital correct that this is the
   normal process?
   - What kind of diagnostic error is this, if it is?
   - What factors contributed to this diagnostic error?
   - And for extra points, did the doctors deserve to be fired for it?
   (Note: there had been previous diagnoses that were reversed.)




*Hospital: No ‘misdiagnosis’ by fired Saints doctors*

NEW ORLEANS — The hospital system employing two recently fired New Orleans
Saints team physicians says its review of the doctors’ work yielded no
evidence of a “misdiagnosis” or even an unusual diagnosis.

The Ochsner Health System review came after the Saints removed orthopedic
surgeons Deryk Jones and Misty Suri from the team’s medical staff last week.

Coach Sean Payton has said the decision came after cornerback Delvin Breaux
learned he needed surgery to repair a fibula fracture that was initially
diagnosed as a bone bruise.

A statement Tuesday by Ochsner CEO Warner Thomas and chief medical officer
Robert Hart says the hospital system “routinely reviews any claims of
questionable diagnosis, and has taken the time do so in this case.”

“Our medical experts have stated that it is not uncommon for stress-related
fractures to be unnoticeable in initial imaging; follow-up diagnostics are
always required when a patient doesn’t show appropriate clinical progress,”
the statement continued. “After a very careful and thorough review, we want
the record to be clear, Drs. Jones and Suri did not ‘misdiagnose’ an injury.

“Ochsner stands behind the clinical knowledge and expertise of our

Payton has said that while Jones and Suri did “a great job” for years, the
decision to make a change was not based on one event. While Payton did not
go into detail about other cases, Breaux is at least the second Saints
starter this year to delay surgery because the initial medical opinion was
that an operation was not necessary. Another was center Max Unger, who
tried to treat foot injury from last season with rest and rehabilitation
before deciding in May to have surgery.

“There was a point at which we just felt as an organization that that
change was going to be necessary,” Payton said last week.

The Saints are in the process of hiring replacement orthopedic surgeons
from New Orleans or nearby areas for the duration of this season.

The removal of Jones and Suri created an awkward situation because Ochsner
is one of the most visible sponsors of the Saints as well as the NBA’s
Pelicans, whose training headquarters this summer were renamed the Ochsner
Sports Performance Center. Both teams are owned by Tom Benson, after whom
Ochsner’s cancer treatment center is named.

Suri, who last year served as a lead orthopedic surgeon for the Pelicans,
remains in that position. It also appears that Ochsner is not ready to let
the doctors’ dismissal by the Saints affect the hospital’s business
relationship with the NFL club.

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Sports news with a focus on D.C. area teams.
“As we have stated previously, Ochsner respects the Saints’ decision to
change team physicians,” the statement said. “We remain deeply committed to
our partnership with the Saints and look forward to working together in the


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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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