Diagnostic Errors Drive Medical Malpractice Claims, says Johns Hopkins Study By Tod Aronovitz | 05/07/13 | 0 Comment

Diagnostic errors are the most common, costly and dangerous medical mistakes in the United States, according to a recent study of medical malpractice claims conducted by Johns Hopkins University.

These errors, including missed, wrong or delayed diagnoses, resulted in $38.8 billion of total claim payments from 1986 through 2010, after adjusting for inflation.

Researchers at the University reviewed more than 350,000 malpractice claims over 25 years and discovered that ‘misdiagnosis’ accounted for nearly 29% of claims, more than ‘treatment,’ ‘surgery’ or ‘medication’ as the cause.

Diagnostic errors made up the biggest share of claim payments at 35.2% of total payments with more than 40% of those claims resulting in death of the patient.

The study uncovered roughly equal numbers of lethal and nonlethal mistakes. Previous estimates of hospital deaths from diagnostic error were about 80,000 per year, suggesting that total diagnostic errors could be as high as 160,000.

The top five patient problems that doctors failed to diagnose correctly disclosed in a 2013 study of errors in primary-care visits include:

  • Pneumonia
  • Worsening congestive heart failure
  • Acute renal failure
  • Cancer
  • Urinary tract or kidney infection

Some leading reasons for misdiagnosis errors, according to JAMA Internal Medicine and Houston VA/Baylor College of Medicine:

  • Breakdown in communication during patient’s initial visit to doctor
  • Doctor fails to refer patient to a specialist
  • Patient doesn’t provide adequate medical history
  • Doctor fails to follow up with patient after diagnosis
  • Diagnostic tests aren’t interpreted correctly

Although the Johns Hopkins team acknowledged the data is imperfect, the study compared closed paid claims from the National Practitioner Data Bank, an electronic repository established in 1986 that keeps all malpractice payments.

Prior studies show that paid claims are usually not frivolous, and malpractice data can be a sign of the widespread seriousness of adverse events.

The study found that the highest payments were for severe, permanent neurological damage. While the data didn’t show the cause of the damage, David Newman-Toker, lead author of the study and an associate professor of neurology at Hopkins, estimates there are 100,000 missed strokes annually in the United States.

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