Medico-Legal aspects of an unusual complication from an ear swab test: was the procedure necessary?

A 65-year-old woman affected by chronic pruritus in both ears was referred by her family physician to a private laboratory to undergo an ear swab test for microbiological and cultural examination. During the procedure on the right side, the patient experienced sudden pain, immediately followed by auricular fullness and dizziness. The clinician performing the swab did not perform an otoscopy and did not administer any topical or general medications. A few days later, purulent discharge appeared. Follow-up showed tympanic membrane perforation and mixed severe hearing loss. Indications for ear swab tests are currently unclear, and complications deriving from this apparently simple procedure are seldom reported.