# Handling Complaints Related to Diagnostic Faults Before Disciplinary Bodies: Analysis of French Ordinal Jurisprudence

## TL;DR

This paper analyzes French medical disciplinary cases involving diagnostic faults to clarify ethical and legal responsibilities of physicians.

## Contribution

The study provides a classification of diagnostic fault situations and compares French and Moroccan disciplinary procedures.

## Key findings

- General practitioners were involved in 45% of diagnostic fault cases reviewed.
- Delayed and erroneous diagnoses were the most common reasons for disciplinary action.
- Firm suspensions were the most frequent sanction in 21% of cases.

## Abstract

Introduction

Diagnostic faults are a major source of medical litigation, potentially engaging the disciplinary responsibility of physicians. The distinction between diagnostic fault and diagnostic error is often misunderstood, which can lead to unjustified sanctions or ignorance of ethical obligations. This study aims to clarify the concept of diagnostic fault as an ethical breach and to identify situations that may engage the physician’s disciplinary responsibility. It further highlights the ethical and medicolegal challenges posed by diagnostic errors, providing insights into their implications for deontological and legal frameworks.

Materials and methods

This is a descriptive and analytical retrospective study of 73 disciplinary procedures for diagnostic faults judged by the National Disciplinary Chamber of the French Medical Council between 2012 and 2020. Data were collected from the jurisprudence database of the National Council of the French Medical Council. Inclusion criteria included cases where a diagnostic fault was invoked. Cases in which no diagnostic fault or delay was alleged at the outset against the physician were excluded from the analysis. A descriptive statistical analysis was performed.

Results

Among the 73 cases reviewed by the disciplinary chamber, several involved multiple complainants. General practitioners were the most frequently implicated, accounting for 45% of cases. Of the cases examined, 33 (45%) were dismissed due to insufficient evidence or absence of fault. Delayed diagnoses (22%) and erroneous diagnoses (21%) emerged as the most frequently retained reasons. Finally, firm suspensions, ranging from 8 days to 2 years, were the most common sanction, imposed in 15 cases (21%).

Discussion

Diagnostic faults represent a significant portion of disciplinary litigation. Situations leading to these faults can be classified into three categories: lack of attention during diagnosis, absence of appropriate complementary investigations, and failure to consult a competent third party. Comparison with Moroccan legislation reveals differences in disciplinary procedures, particularly in terms of transparency and procedural safeguards.

Conclusion

A diagnostic fault is an ethical breach that can engage the physician’s disciplinary responsibility. A better understanding of ethical obligations and continuous training is essential to reduce these faults. Disciplinary procedures should be revised to include guarantees of a more transparent and equitable process.