The landscape of pediatric healthcare has changed dramatically over the last few years. By now, in 2026, virtual visits have transitioned from an emergency alternative to a household staple. For many families, the convenience of a telehealth appointment is undeniable. You can consult a doctor from your living room, avoid a crowded waiting room, and get a prescription for a minor ear infection or a skin rash within minutes.

But as telehealth becomes a common part of care for many routine ailments, we must address a growing concern: the screen-only diagnosis. While technology has advanced, it has not yet replaced the essential value of a physical, hands-on examination. When a medical provider relies solely on a video feed to evaluate a child, subtle but life-altering symptoms can be missed. In the world of pediatric medicine, where children often cannot articulate their own pain, the lack of physical touch can lead to devastating consequences.

The Standard of Care in a Digital World

A common misconception among parents is that a telehealth visit has a lower legal or medical standard of care because of its inherent limitations. From a legal standpoint, this is incorrect. Whether a physician sees your child in a state-of-the-art clinic or through a smartphone screen, they are held to the same standard: the level of care and skill that a reasonably competent healthcare professional would provide under similar circumstances.

If a condition requires a physical palpation, a stethoscope to the chest, or a close-up look at the back of the throat to reach an accurate diagnosis, the doctor has a duty to recognize that telehealth is insufficient. In New Jersey, providers must obtain consent for telehealth in a form that is appropriate under the standard of care, and they must refer the patient to appropriate follow-up care where necessary, including in-person or emergency care when needed. If they proceed with a screen-only assessment for a complex issue when telehealth is not consistent with the standard of care, it can raise serious patient-safety concerns and potential malpractice liability.

Where the Screen Fails: High-Risk Pediatric Conditions

There are certain medical emergencies where a physical exam is not just helpful, but often necessary to safely evaluate a child. As telehealth has become more common, some families have raised concerns about missed or delayed diagnoses in situations where a hands-on exam would normally be part of a careful pediatric evaluation.

Pediatric Appendicitis and Abdominal Tenderness

Appendicitis is a common concern in pediatric abdominal-pain cases, in part because timing and accurate evaluation matter. A key part of evaluating possible appendicitis is a hands-on abdominal exam, including palpation. An in-person doctor can assess for rebound tenderness or guarding, which are physical responses to pressure. Through a screen, a doctor might ask you to press on your child’s belly, but a parent’s touch is not a substitute for a trained physician’s hands.

If a doctor misses a ruptured appendix because they tried to diagnose abdominal pain over a video call, the delay in treatment can lead to sepsis or long-term internal damage.

Respiratory Distress and Visual Noise

When a child has a respiratory infection, a doctor needs to hear the specific crackles or wheezing in the lungs and observe the retraction of the chest muscles. While high-definition video has improved, visual noise caused by poor lighting or low frame rates can mask the signs of labored breathing.

A virtual provider might dismiss a child’s fast breathing as a normal reaction to a fever, when an in-person exam can help identify signs consistent with pneumonia or Respiratory Syncytial Virus (RSV).

Neurological Issues and Gait Changes

Subtle changes in a child’s movement, such as a slight limp or a lack of coordination, can be early warning signs of neurological emergencies or tumors. These are often difficult to capture on a webcam in a cramped living room or via a lagging video feed. A standard of care for pediatric telemedicine generally requires that if a child’s motor skills or neurological reflexes are in question, an in-person exam is often the safest path forward. Relying on a screen to clear a child of neurological concerns can lead to the delayed diagnosis of life-threatening conditions.

The Hidden Risks of Technical Limitations

Even with the best intentions, the technology used in telehealth can create a false sense of security. Several factors can contribute to a missed or delayed diagnosis during a virtual visit:

• Low Resolution and Lighting: Subtle skin discolorations, such as the faint purple spots associated with meningitis (petechiae), can be easily missed if the video quality is not perfect or if the room is too dark.
• Audio Lag: When a doctor is listening to a child’s cough or speech patterns, even a half-second of lag can distort the sound, leading the provider to believe a condition is less severe than it truly is.
• The Snapshot Problem: A telehealth visit is a brief snapshot in time. Unlike a hospital setting where a child can be monitored over several hours, a virtual visit often lacks the follow-up necessary to see if a child’s condition is rapidly deteriorating.

Can You Sue a Telehealth Doctor for a Child’s Injury?

If your child has suffered a permanent injury or a significant setback because of a virtual misdiagnosis, you may wonder about your legal options. The answer is yes: you can pursue a claim against a telehealth provider, but these cases are complex.

To prove malpractice in a virtual setting, we must demonstrate that the provider’s decision to use telehealth was itself a breach of the standard of care. This often involves showing that the child’s symptoms were red flags that should have prompted an immediate referral to an emergency room. For example, if a parent reports that an infant is lethargic and has a high fever, and the telehealth doctor merely suggests a change in fluids instead of an in-person exam, that doctor may be held liable for any resulting harm, such as a missed diagnosis of bacterial meningitis.

Crucially, under N.J.S.A. 45:1-62, the provider must refer the patient to appropriate follow-up care where necessary, including referrals for in-person care or emergency care if needed. For patients without a primary care provider, the provider may advise the patient to contact one and, upon the patient’s request, must assist the patient with locating a primary care provider or other in-person medical assistance within reasonable proximity. These follow-up and continuity obligations are often overlooked by families after a virtual visit.

Protecting Your Child: When to Demand an In-Person Visit

As a parent, you are your child’s best advocate. While telehealth is a valuable tool, it is important to know its limits. We recommend that you insist on an in-person evaluation if your child exhibits any of the following:

• Persistent or severe abdominal pain that makes it difficult for the child to walk or stand straight.
• A fever in an infant under three months of age, which generally warrants prompt in-person medical evaluation.
• Any difficulty breathing, including whistling sounds or the pulling in of the skin around the ribs.
• A rash that does not turn white when you press on it.
• Symptoms that have not improved or have worsened after a previous telehealth consultation.

If you ever feel that a virtual doctor is brushing off your concerns or not seeing the full picture, do not hesitate to end the call and head to the nearest pediatric urgent care or emergency department.

Understanding Your Rights in Pediatric Telemedicine: Contact a New Jersey Malpractice Lawyer Today

Telehealth is here to stay, and in many ways, it has made healthcare more accessible for families. That being said, accessibility should never come at the cost of accuracy. By understanding the hidden risks of screen-only diagnoses and knowing when to demand an in-person exam, you can help ensure your child receives the quality of care they deserve.

The Pediatric Malpractice Guide is dedicated to providing families with the information they need to navigate the complexities of modern healthcare. Technology should enhance medical care, not compromise it. When a healthcare system prioritizes the efficiency of telehealth over the safety of the patient, the most vulnerable members of our society, our children, pay the price.

If you believe your child was the victim of a telehealth misdiagnosis, remember that you have the right to seek answers and accountability. The transition to digital medicine does not grant providers a license to be negligent. This guide is here to help families understand the standard of care and provide the resources necessary to protect a child’s future.

If you have questions about a potential medical error or the legal obligations of a virtual provider, please reach out to Fronzuto Law Group today to discuss your situation and explore your options for moving forward.

Disclaimer: The information provided in this blog is for educational and informational purposes only and does not constitute legal or medical advice. No attorney-client relationship is formed by reading this post. If you are seeking legal advice regarding a specific situation, please contact a qualified professional directly.