Research Day

Patient Misunderstanding Of Findings Leads To Suicide

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INTRODUCTION: Our words as physicians carry great weight. Occasionally, we can become numb to the sway we have on the lives of our patients. Patient misinterpretation of our words can have devastating consequences.

PURPOSE: The purpose of this presentation is to highlight a case where a patient's misunderstanding of information provided resulted in her tragic suicide.

MATERIALS: The case is from the files of one of the authors (JP).

RESULTS: A 75-year-old woman with a history of chronic obstructive pulmonary disease, atrial fibrillation, and hypertension presented to an Emergency Department with complaints of worsening constipation, epigastric pain, and nausea of 3-days' duration. Physical exam was nonspecific. A computed tomography scan revealed bilateral cystic and solid adnexal masses concerning for ovarian neoplasms. She was referred to an oncologist. Two days later, before seeing the oncologist, she was found dead in her bed, with a suicide note present. Subsequent medicolegal autopsy revealed that she died from a suicidal overdose of multiple medications, but that the bilateral ovarian tumors were, in fact, benign cystic adenofibromas.

DISCUSSION: The patient wrongly assumed that the referral to an oncologist and mention of tumors meant that she had cancer. This discrepancy of understanding had dire consequences. Had her care providers understood her misinterpretation of the findings in this case, her tragic death might have been avoided.

CONCLUSION: The case serves to remind physicians and all healthcare professionals as to the importance of establishing a mutual understanding with patients.

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