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Case Reports
. 2021 Jan:78:210-213.
doi: 10.1016/j.ijscr.2020.12.052. Epub 2020 Dec 24.

The missing spleen - A diagnosis of medical identity fraud in surgery: Case report

Roy Huynh  1 , Alexandra Thoms  2 , Thuy-My Nguyen  2 , Titus Kwok  2
Affiliations
Case Reports

The missing spleen - A diagnosis of medical identity fraud in surgery: Case report

Roy Huynh et al. Int J Surg Case Rep. 2021 Jan.

Abstract

Introduction and importance: Medical identity fraud is a growing concern in surgery and can adversely affect patient care. Fraudulent medical information can result in misdiagnoses or inadequate preoperative workup of surgical patients.

Case presentation: A 63-year-old female presented to hospital with a fishbone-related oesophageal perforation. Unbeknownst to the surgical team, the patient was committing medical identity fraud and impersonating another 57-year-old female. She underwent a gastroscopy with removal of the fishbone while her true identity remained concealed. A progress CT scan performed three days post-gastroscopy revealed an absent spleen, which was present on ultrasound as recent as three weeks prior to her admission. The patient was confronted about this discrepancy and confessed to committing medical identity fraud.

Clinical discussion: Detection of medical identity fraud remains a challenging problem in healthcare systems worldwide. Various methods have been proposed to improve detection of medical identity fraud but there has been limited studies on their effectiveness in hospital settings. Given the serious health repercussions that can arise from medical identity fraud, it is imperative that better detection methods become available in the future.

Conclusion: Medical identity fraud is a complex problem that requires better detection methods to prevent patient harm. Surgeons should be aware of the adverse health consequences that can arise from medical identity fraud.

Keywords: Case report; Endoscopy; Foreign body ingestion; Medical identity fraud; Medicolegal; Surgery.

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Figures

Fig. 1
Fig. 1
Endoscopic images showing the site of esophageal perforation (right) caused by ingested fishbone (left).
Fig. 2
Fig. 2
Transverse CT slice showing an absent spleen as denoted by a question mark.
Fig. 3
Fig. 3
Abdominal ultrasound of left upper quadrant showing (A) spleen and (B) left kidney.
See this image and copyright information in PMC

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