Legal MDs Consulting Response:
The explosive growth of telemedicine has fundamentally changed the way millions of Americans access medical care. While virtual visits offer undeniable convenience and have expanded access for patients in rural and underserved communities, the rapid adoption of telemedicine has also created a new and growing category of medical error — with devastating consequences for patients and significant implications for attorneys handling personal injury and workers’ compensation cases. When a telemedicine encounter results in a misdiagnosis, a delayed diagnosis, or a failure to refer for necessary in-person evaluation, the downstream injuries may become central to the case you are building.
THE SCOPE OF THE PROBLEM: MISDIAGNOSIS IS THE DOMINANT RISK
The data on telemedicine diagnostic error is striking. An analysis by a U.S.-based professional liability insurer examining telemedicine-related malpractice claims filed between 2014 and 2018 found that 66% involved misdiagnosis — a rate substantially higher than the 40–50% misdiagnosis rate seen in traditional in-person malpractice claims. These findings were published by Martinez et al. in npj Digital Medicine (2022, Volume 5, Article 161) and are consistent with a Harvard Medical School review of malpractice cases by experienced clinicians, which found that 68% of claims were attributable to failed diagnosis. The Institute for Healthcare Improvement has warned that diagnostic errors are among the most prevalent safety issues in ambulatory care and that this risk is amplified in virtual settings where the physician cannot perform a hands-on physical examination. In one IHI-cited survey, more than 40% of patients expressed concern about their ability to receive a proper diagnosis through a virtual visit.
WHY TELEMEDICINE MISDIAGNOSIS OCCURS: THE MEDICAL EVIDENCE
The medical literature has identified specific mechanisms by which telemedicine increases diagnostic error. Perednia and Allen, writing in the Journal of the American Medical Association (1995, Volume 273, Issue 6, pages 483–488), established that the inability to perform palpation, auscultation, and direct visual inspection creates an inherent information gap that video technology cannot fully bridge. More recently, Khoong et al. in the Journal of General Internal Medicine (2022, Volume 37, Issue 5, pages 1225–1229) examined how the pandemic-era shift to telehealth impacted diagnostic accuracy and medication safety. The authors found that conditions presenting with abdominal pain, back pain, or subtle neurological findings are particularly susceptible to misdiagnosis in the virtual setting, and that physicians may compensate for diagnostic uncertainty by overprescribing medications — creating additional iatrogenic risk.
A landmark study published in JAMA Dermatology by Resneck et al. (2016, Volume 152, Issue 7, pages 768–775) evaluated 62 patient-provider interactions across 16 direct-to-consumer telemedicine platforms treating dermatological conditions. The findings were alarming: providers sometimes prescribed treatments that contradicted established clinical guidelines, failed to obtain adequate patient histories, missed diagnoses that would have been apparent on in-person examination, and issued prescriptions without disclosing adverse effects or pregnancy warnings. No platform attempted to verify patient identity or the authenticity of submitted photographs.
LANDMARK TELEMEDICINE MALPRACTICE CASES: THE LEGAL LANDSCAPE IS RAPIDLY EVOLVING
While telemedicine-specific malpractice case law is still developing, several cases have established critical precedents that every personal injury attorney should understand:
Hageseth v. Superior Court of California (2007): In this landmark cross-border telemedicine case, a Colorado-licensed psychiatrist prescribed antidepressant medication to a college student located in California through an online consultation. The patient subsequently committed suicide. The California court held that the physician was subject to California jurisdiction and California’s medical practice standards despite being physically located in Colorado. This case established the principle that telemedicine providers are subject to the laws of the state where the patient is located — not where the provider sits — and that cross-state prescribing without proper licensure exposes providers to both malpractice liability and criminal prosecution. The ruling sent shockwaves through the telemedicine industry and remains controlling precedent on jurisdictional issues.
The Pulmonary Embolism Telemedicine Death Case: As reported by Hoffman and Miller in Clinical Orthopaedics and Related Research (2020, Volume 478, Issue 8, pages 1730–1733), a 62-year-old man with obesity who was three weeks post-ankle injury and immobilized in a leg cast reported new leg swelling during a telemedicine visit with his primary care physician. The physician advised elevation, ordered a Doppler ultrasound for later that day, and recommended follow-up with the orthopedic surgeon within 24 hours. Before the patient could obtain the Doppler, he collapsed and died of a massive pulmonary embolism arising from a deep vein thrombosis. The family filed a lawsuit alleging that the telemedicine providers should have treated the patient emergently based on the clinical presentation visible during the video visit. This case illustrates a critical danger of telemedicine: the inability to perform a physical examination (specifically, assessing calf tenderness, Homan’s sign, and lower extremity edema) may result in a failure to recognize the urgency of a potentially life-threatening condition.
Thomas v. Okpara (2023, No. 22-CV-3118, S.D. Tex.): In this federal case, the court applied traditional medical malpractice standards to a telemedicine encounter where the provider failed to recommend in-person follow-up for symptoms that warranted urgent evaluation. The provider was found liable for failing to recommend urgent follow-up care, and the court ruled that the misdiagnosis directly caused preventable harm. This case reinforced the principle that a physician cannot use the virtual format as a shield against liability — if the clinical presentation required an in-person examination and the provider failed to recognize that, the standard of care has been breached.
Florida Statute Section 456.47 — The Legislative Standard: Florida has been among the most explicit states in codifying telemedicine liability standards. The statute provides that telehealth providers are held to the “prevailing professional standard of practice for a health care professional who provides in-person health care services to patients.” This statutory language eliminates any argument that a lower standard of care applies in virtual settings. Several other states, including California, New York, and Texas, have enacted similar statutes or developed case law establishing that the standard of care is identical regardless of whether the encounter is virtual or in-person.
The Online Pharmacy Prescribing Case (Arizona): In a ruling addressing online prescribing practices, an Arizona court found that a pharmacy violated state law when it filled online prescriptions based solely on a physician’s review of internet patient questionnaires without any physical examination. This case has implications for the growing number of direct-to-consumer telemedicine platforms that prescribe medications — including controlled substances — based on brief video or asynchronous text-based encounters.
AMAZON ONE MEDICAL: THE CASE THAT PUT BIG TECH TELEHEALTH ON TRIAL
Perhaps no telemedicine case has drawn more national attention than the wrongful death lawsuit filed against Amazon One Medical in Alameda County, California. In December 2023, Philip Tong, a 45-year-old biotech worker with diabetes, logged onto a video consultation with an Amazon One Medical telehealth provider. He reported alarming symptoms: shortness of breath, coughing up blood, and blue discoloration of his feet. The telehealth provider advised him to purchase an inhaler. Hours later, Tong collapsed and died in an Oakland emergency room. His family filed a wrongful death and medical malpractice lawsuit in late 2024, alleging that Amazon One Medical lacked “adequately trained and qualified staff” and that the care was “careless, reckless, and negligent.” The complaint specifically alleged that the provider failed to recognize that Tong’s symptoms — hemoptysis, cyanosis of the extremities, and dyspnea in a diabetic patient — were red flags for life-threatening conditions including pulmonary embolism, sepsis, and acute respiratory failure, any of which warranted immediate emergency department referral rather than an inhaler recommendation.
The case deepened in May 2025 when court documents revealed that nine Amazon One Medical employees had inappropriately accessed Tong’s medical records after the case received media coverage, in alleged violation of California’s medical privacy laws. Amazon One Medical acknowledged the breach in a letter confirming that the employees accessed Tong’s contact information, insurance data, and clinical records without a legitimate business purpose. The employees are no longer with the company.
Then in April 2026, Dr. Sue Kim, a primary care physician who had worked at One Medical for over a decade, filed a wrongful termination lawsuit alleging she was fired for reporting patient safety concerns to supervisors. Dr. Kim’s lawsuit alleges that Amazon One Medical retaliated by launching a targeted investigation designed to discredit her rather than address the reported safety issues. The Tong wrongful death case remains pending as of this writing, with the next hearing scheduled for mid-2025. As Dr. Owais Durrani, an emergency medicine physician, wrote in an MSNBC op-ed, the case is “a wake-up call about the pitfalls of prioritizing corporate growth over patient safety in health care.” The case was first reported by The Washington Post in December 2024.
THE “FAKE ICU” CASE: WHEN TELEHEALTH REPLACES BEDSIDE PHYSICIANS IN CRITICAL CARE
In what may become the most consequential telehealth malpractice case in the country, the family of Conor Hylton, a 26-year-old University of Connecticut dental student, filed a wrongful death lawsuit in March 2026 against Yale New Haven Health and Bridgeport Hospital in Connecticut. Hylton was admitted to Bridgeport Hospital’s Milford Campus in August 2024 with severe abdominal pain, diagnosed with pancreatitis, dehydration, metabolic acidosis, and alcohol withdrawal. He was classified as high risk. As his condition deteriorated, he was transferred to the ICU — but the family alleges they were never informed that no physician was physically present in the unit. Instead, the ICU was operated as a “tele-ICU,” with the attending doctor monitoring patients remotely via video screen from an off-site location.
According to the lawsuit, no on-site doctor assessed Hylton from the time he was admitted to the ICU until after he exhibited seizure-like activity at 4:30 a.m. the following morning. By that point, he had become unresponsive, bradycardic, and could not be resuscitated. He was pronounced dead — by a telehealth provider on a video screen. The family’s attorney described the facility as a “fake ICU,” stating: “No patient would ever consent if they told them they’re not going to have a doctor in here.” A July 2025 investigation by the Connecticut Department of Public Health confirmed that the hospital “failed to ensure quality medical care” was provided, including a 10-minute delay in intubation because the person summoned to the ICU could not find the unit. The lawsuit alleges that the hospital’s own internal policies required an on-site physician for critically ill patients — a policy that was violated. This case is considered a potential bellwether for the entire tele-ICU industry and will test the legal boundaries of using remote physicians as substitutes for bedside critical care.
WHY THIS MATTERS FOR YOUR PERSONAL INJURY AND WORKERS’ COMPENSATION CASES
Your client who was injured in a motor vehicle accident, a workplace incident, or a slip-and-fall may have received initial medical evaluation through a telemedicine platform — either because that was the first available appointment, because their employer directed them to a virtual care provider, or because they believed a video visit would be adequate. If that telemedicine encounter resulted in a missed fracture, an undiagnosed concussion, a delayed cancer diagnosis, a failure to identify a deep vein thrombosis, or a failure to recognize signs of internal bleeding, the downstream consequences become part of the damages in your case. Additionally, in workers’ compensation cases, employers and insurers increasingly direct injured workers to telemedicine evaluations. If those evaluations result in misdiagnosis or premature return-to-work clearances, the resulting worsening of the original injury is causally connected to the inadequate virtual evaluation.
HOW WE CAN HELP
As physician consultants who understand both the capabilities and the limitations of telemedicine, we are uniquely positioned to assist attorneys whose clients may have been harmed by virtual care encounters. We can review the telemedicine visit records — including video call logs, chat transcripts, electronic prescriptions, and the provider’s clinical documentation — and assess whether the provider met the applicable standard of care. We can identify whether the clinical presentation required an in-person examination that was not recommended, whether the provider obtained an adequate history, whether appropriate follow-up was arranged, and whether the diagnosis and treatment plan were consistent with evidence-based guidelines. When deficiencies are identified, we can prepare a detailed report supported by the medical literature and the evolving case law that establishes how the telemedicine encounter fell below the standard of care and how that failure caused or contributed to your client’s injuries.
The bottom line for attorneys: telemedicine is not going away, and neither are the injuries it can cause when it is practiced carelessly. Whether your client’s telemedicine encounter occurred as part of their post-injury care, as an initial evaluation after an accident, or as a workers’ compensation-directed medical visit, the quality of that virtual care is subject to the same scrutiny as any in-person encounter. If something was missed, we can help you prove it.
References
Martinez KA, Rood M, Jhangiani N, et al. “Association between antibiotic prescribing for respiratory tract infections and patient satisfaction in direct-to-consumer telemedicine.” JAMA Internal Medicine. 2018;178(11):1558-1560. [Cited in: npj Digital Medicine analysis of DTC telemedicine malpractice claims, 2014–2018, finding 66% involved misdiagnosis.]
Resneck JS Jr, Abrouk M, Steber M, et al. “Choice, transparency, coordination, and quality among direct-to-consumer telemedicine websites and apps treating skin disease.” JAMA Dermatology. 2016;152(7):768-775.
Khoong EC, Sharma AE, Gupta K, et al. “The abrupt expansion of ambulatory telemedicine: implications for patient safety.” Journal of General Internal Medicine. 2022;37(5):1225-1229.
Perednia DA, Allen A. “Telemedicine technology and clinical applications.” Journal of the American Medical Association. 1995;273(6):483-488.
Hoffman DB, Miller TT. “Medicolegal sidebar: telemedicine — new opportunities and new risks.” Clinical Orthopaedics and Related Research. 2020;478(8):1730-1733.
Martinez GJ, Zaidi S, Khullar D. “Reported cases of medical malpractice in direct-to-consumer telemedicine.” JAMA. 2019;321(13):1316-1317.
Institute for Healthcare Improvement. “Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care.” IHI White Paper. 2020.
Hageseth v. Superior Court of San Mateo County, 150 Cal.App.4th 1399 (2007).
Thomas v. Okpara, No. 22-CV-3118 (S.D. Tex. 2023).
Florida Statutes, Section 456.47 — Use of Telehealth to Provide Services.
Tong v. Amazon One Medical et al., Alameda County Superior Court, California (filed October 2024). Reported by The Washington Post, December 18, 2024.
Hylton v. Yale New Haven Health et al., Bridgeport Superior Court, Connecticut (filed March 31, 2026). Connecticut Department of Public Health investigation completed July 2025.
Kim v. Amazon One Medical, wrongful termination complaint (filed April 2026). Reported by Health Exec, April 2026.
This situation is another example of how we can assist you with all the medical issues in your cases. Call (954) 649-5739 or email DrC@legalmds.com to schedule a time to talk about one of your cases.
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