According to a recent study of closed medical malpractice claims, diagnostic errors are the single largest root cause of medical negligence claims. According to the Centers for Disease Control and Prevention, 10-20% of all diagnoses are inaccurate.
The next seven most frequent causes of medical malpractice lawsuits are, in order of magnitude, surgical/procedural, medical management, medication related, patient environment/safety, obstetrics -related (prenatal care and labor and delivery), patient monitoring, and anesthesia-related errors. Interestingly, the top of medical conditions for this type of medical negligence claim include cancer, infections, cardiac/vascular, fractures/dislocations, and myocardial infarctions (MI or heart attack).
As a Houston, Texas medical malpractice attorney, I think that this type of research has an excellent value to both patients and healthcare providers. For physicians, nurse practitioners, physician assistants, and other healthcare providers, it sheds light on poor practices that should be avoided. For patients, it creates an awareness of common errors that may trigger helpful questions.
According to the study, diagnosis-related medical errors begin with the first patient encounter with a healthcare provider and continue through the follow-up phase, after evaluation and testing. The top diagnosis-related allegations include:
· Performing an adequate history and physical/evaluation of the patient. In my experience, physicians frequently are rushed and in a hurry to get to the next patient. If they do not collect all of the relevant information, but instead make a presumption or record something that is inaccurate, it can be the snowball that creates an avalanche. One case comes to mind where someone on the emergency room staff at a major hospital in the Texas Medical Center, in Houston, jumped to the wrong conclusion that a young lady presenting with stroke symptoms was actually suffering from a hangover. She was discharged home, where she had a massive stroke.
· Mistakes in ordering, or not ordering, appropriate diagnostic/lab tests. The only way for doctors to safely treat a patient is to make a list of all potential conditions that explain the patient’s symptoms and then order testing to rule in or rule out each of those conditions.
· Mistakes in performing tests.
· Mistakes in communicating or handling test results. In my legal career, I have seen case after case where a test was ordered, but communication of the results was bungled. Sometimes electronic test results appear in the medical records, but no one is notified about them, so they are never reviewed. In other instances, there can be a critical result, but the lab or radiologist does not pick up the phone and inform the provider who ordered the test. These delays are dangerous and can be deadly.
· Mistakes in communicating or handling test results.
· Misinterpreting test results.
· Not making appropriate consultation referrals to medical specialists, or mismanaging them. Primary care providers are equipped to handle common conditions, but must use care to refer patients to a specialist, when needed. The primary care provider needs to be in close communication with a specialist to make sure that nothing falls through the cracks.
· Poor physician follow-up with patients.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
