Medical malpractice: Where doctors are making costly mistakes
We have all heard about medical mistakes made in the operating room from sponges left inside a patient or performing surgery on the wrong body part. But a new study shows medical malpractice payout claims come mostly from missing or making the wrong diagnosis.
The new analysis uncovers high amounts of money paid in medical claims from missing a health condition, delay in discovering a serious health condition and inappropriate treatment for misdiagnosis over a period of 25 years.
Compared to other medical errors, mistakes in diagnosing accounted for the highest cost and harm to patients.
The study, conducted by Johns Hopkins University School of Medicine looked at medical malpractice claims between 1986 and 2010. Researchers discovered diagnosis-related payments amounted to $38.8 billion.
David E. Newman-Toker, M.D., Ph.D., an associate professor of neurology at the Johns Hopkins University School of Medicine and leader of the study published online in BMJ Quality and Safety said in a press release missed, delayed or wrong diagnoses have been underappreciated and largely unrecognized.
The investigators say missed, wrong or delayed diagnosis likely affects 80,000 to 180,000 patients annually.
Newman-Toker says experts have not talked about the problem much because they do not want to open a "can of worms", but most are aware of the scope of the problem.
"Progress has been made confronting other types of patient harm, but there's probably not going to be a magic-bullet solution for diagnostic errors because they are more complex and diverse than other patient safety issues. We're going to need a lot more people focusing their efforts on this issue if we're going to successfully tackle it”, he says.
The analysis showed most diagnostic related errors occurred among patients receiving outpatient testing versus in a hospital or other inpatient setting, though inpatient errors when they were discovered were more lethal.
Diagnostic errors accounted for 28.6 percent of 350,706 paid claims. Most were related to missing a health problem as opposed to delays or the wrong diagnosis.
The highest amount of money paid out for medical damages was related to neurological problems such a paralysis that resulted in the need for life-long care. Payouts were higher than those resulting from medical diagnostic errors.
The number of errors that resulted in lethal or severe harm matched the number of claims.
Harm to patients from diagnosis errors probably has a much bigger impact on public health than known, the authors suspect. The analysis only took into account the most severe outcomes of diagnostic errors. One estimate from the analysis suggests as high as a 15 percent error rate in diagnosing a new problem.
Despite tens of billions hat are spent every year on "defensive medicine for fear of missing something, mistakes are still made that have dire consequences for patients.
Newman-Toker says there is no simple solution to the problem, but not enough attention has been paid to diagnostic errors that cost billions and are more common than treatment mistakes.
April 22, 2013
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