Can a Mismanaged Chronic Condition Lead to a Malpractice Claim?

Living with a chronic condition requires consistent and well-coordinated medical care to manage symptoms, prevent complications, and maintain an individual’s quality of life. When healthcare providers fail to monitor or treat chronic conditions properly, the consequences can be severe and even life-threatening. In some cases, mismanagement of these conditions may constitute medical malpractice, giving patients the right to pursue legal action.

Chronic Conditions and Their Treatment

A chronic condition is a long-term illness requiring ongoing medical attention and lifestyle adjustments. 

Common chronic conditions include:

• Diabetes
• Hypertension (high blood pressure)
• Heart disease
• Asthma
• Chronic kidney disease

These conditions can worsen over time if not properly managed, leading to serious complications such as heart attacks, strokes, organ failure, or neuropathy. For many patients, regular medical monitoring, medication adjustments, and lifestyle interventions are critical to controlling symptoms and preventing escalation.

Consistent medical care is essential for patients with chronic conditions. Diabetes patients, for example, require regular blood sugar monitoring, insulin adjustments, and foot exams to avoid complications like nerve damage or amputation. Likewise, heart disease patients must receive routine evaluations, medication management, and dietary guidance to prevent cardiac events.

Mismanagement of a chronic condition occurs when healthcare providers fail to adhere to the standard of care expected for that condition. 

Mismanagement situations can involve:

• Failure to monitor the patient’s condition: Skipping routine exams or tests necessary to track a condition’s progression.
• Incorrect medication management: Prescribing the wrong medication or dosage or failing to adjust medications when needed.
• Poor follow-up care: Failing to check in on a patient after a major medical intervention or hospital visit.

When chronic conditions are not properly managed, the results can be devastating. For example, failing to control high blood pressure can lead to a stroke, while poor management of diabetes can cause serious infections or even blindness.

When Mismanagement Constitutes Medical Malpractice

Medical malpractice occurs when a healthcare provider fails to meet the accepted standard of care, resulting in harm to the patient. In chronic conditions, malpractice can arise when a provider’s negligence causes the condition to worsen or leads to additional complications. At LawMD, our attorneys are also licensed physicians who can help you navigate the medical and legal aspects of your malpractice case.

For malpractice to be proven, four key elements must be established:

• Duty of Care: The healthcare provider was responsible for providing appropriate care based on the patient’s condition.
• Breach of Duty: The provider failed to meet the standard of care expected for that condition.
• Causation: The provider’s failure directly caused the patient’s condition to worsen or resulted in a new complication.
• Damages: The patient suffered physical, emotional, or financial harm due to the provider’s negligence.

Various circumstances illustrate how mismanagement of chronic conditions can lead to a malpractice claim:

• Failure to Adjust Medications: A patient with hypertension relies on their doctor to adjust medication as their condition changes. If the doctor fails to increase or change medication despite clear signs of worsening blood pressure, the patient may suffer a stroke. This failure to act could be considered negligence.
• Ignoring Patient Complaints: A diabetic patient reports recurring foot infections to their doctor, but the doctor dismisses the complaints without further investigation. Over time, the infections lead to severe damage, requiring amputation. The doctor’s failure to address the patient’s concerns could constitute malpractice.
• Poor Follow-Up Care: A patient recently diagnosed with chronic kidney disease does not receive adequate follow-up care after a hospital stay. Without proper monitoring and intervention, the condition progresses to kidney failure, requiring dialysis. In this case, failure to provide ongoing care could be grounds for a malpractice claim.

Washington D.C. law provides clear guidelines for establishing negligence in medical malpractice cases. Patients must demonstrate that the healthcare provider deviated from the standard of care that would reasonably be expected from a similarly qualified professional in similar circumstances. This legal standard is essential for proving that mismanagement of a chronic condition was not merely a mistake but a breach of duty that directly harmed the patient.

Statute of Limitations

Under D.C. Code § 12-301, the statute of limitations generally provides three years to file a medical malpractice claim. However, in cases of chronic condition mismanagement, determining when “the time the right to maintain the action accrues” can be challenging. 

Mismanagement of chronic conditions can result in gradual worsening over time rather than an immediate and identifiable injury. This delayed realization complicates determining when the statute of limitations begins. The accrual of the right to file a lawsuit might hinge on the moment when the patient reasonably knew — or should have known — that their worsening condition resulted from mismanagement. 

Courts may consider factors such as:

• When did the patient first experience signs that their condition was improperly managed?
• Did the patient have regular follow-up care or seek a second opinion?
• When did the patient receive a diagnosis that indicated prior mismanagement?

Determining the starting point for legal action in these cases often involves the “discovery rule,” which allows the statute of limitations to begin when the patient becomes aware (or reasonably should have become aware) of the negligence rather than when the mismanagement first occurred. However, applying the discovery rule in chronic condition cases can be complex, as it may be difficult to pinpoint when the patient became aware of the negligence, especially if the decline in health was gradual.

Filing a Malpractice Claim for Chronic Condition Mismanagement

If you believe your chronic condition has been mismanaged and resulted in significant harm, you may have grounds for a medical malpractice claim. The first step in evaluating your case is determining whether your healthcare provider’s actions (or lack of action) meet the legal definition of negligence.

Important steps to follow when filing a malpractice claim for mismanagement of a chronic condition include:

• Consult a Medical Malpractice Attorney: It is essential to consult an experienced attorney specializing in medical malpractice cases. They can review your medical records, evaluate the facts of your case, and advise you on the likelihood of proving negligence.

• Gather Medical Records: Obtaining your complete medical records is essential to proving malpractice. These records will show the treatments you received, any changes in your condition, and whether the healthcare provider took appropriate steps to manage your chronic condition.

• Obtain Expert Testimony: Medical malpractice cases often rely on expert testimony to establish whether the healthcare provider’s actions were consistent with the standard of care. Experts can testify regarding what should have been done to manage your condition and how the provider’s failure caused harm.

Seek Compensation for Damages

If you successfully prove malpractice, you may be entitled to compensation for a range of damages, including:

• Ongoing Treatment Costs: Many chronic conditions require ongoing care. If your condition was made worse due to mismanagement, you may be entitled to compensation for additional medical expenses.

• Pain and Suffering: Malpractice can lead to physical pain, emotional distress, and a diminished quality of life. Compensation may be available for these non-economic damages.

• Reduced Quality of Life: If your ability to work, enjoy life, or participate in daily activities has been compromised, you may be entitled to compensation for the loss of quality of life.

Seek Legal Advocacy for Your Medical Malpractice Claim

Mismanagement of a chronic condition can have serious and long-lasting consequences. If you believe a healthcare provider’s negligence worsened your condition or caused additional complications, you may have the right to pursue a medical malpractice claim. At LawMD, as attorneys who are also doctors,  we understand the challenges of managing chronic conditions and the legal standards involved in proving malpractice. 

Contact us today at 844-732-1024 to discuss your case and learn how we can help you seek justice and compensation for your injuries.