A recent study, as reported in the Washington Post, showed that errors in diagnosing patients are the main source of medical malpractice claims. This study, led by Dr. David Newman-Toker, a neurologist at Johns Hopkins University School of Medicine, and Ali Saber Tehrani, looked into 25 years of malpractice payments to discover this fact. The researchers looked into 350,000 medical malpractice claims in which payment was made from 1986 until 2010.
What they mean by diagnostic errors are things like diagnosing appendicitis when the patient has an ectopic pregnancy or diagnosing simple dizziness when the patient is having a brainstem stroke. Often the correct diagnosis is eventually arrived at, but not until the condition is more complicated to treat and has possibly disabled the patient. The study did not delve into why diagnostic errors were so common, but Dr. Newman-Toker said that diagnosis is a difficult and imprecise process and there is often a time lapse between the mistake and when it is discovered, making it also harder to correct in enough time to make a difference. There are also no public reporting requirements for these types of mistakes.
Dr. Newman-Toker said, “Diagnostic errors are the most common, the most costly and the most deadly of all medical errors.” They accounted for 29 percent of successful malpractice claims and 35 percent of the total money paid out. Incorrect, missed, or delayed diagnosis also caused 39 percent of malpractice deaths. Other categories of medical mistakes listed were treatment errors and surgical mishaps, the other two largest categories of malpractice claims, obstetric problems, medication errors, and anesthesia errors.
Diagnostic errors have an estimated death toll of 40,000 to 80,000 Americans per year- and about half of them had conditions that could have been successfully treated if diagnosed correctly. In 41 percent of the diagnostic error cases noted in the study, the patient died, which is the highest percentage in any of the malpractice categories. In terms of money paid out for the errors, errors of diagnosis were second only to obstetric errors and on average patients received $389,000.
By way of potential solutions or ways to reduce these mistakes, Dr. Newman-Toker did not think more tests are necessarily helpful. These tests, like CT scans for everyone complaining of dizziness, cost hundreds of millions of dollars in total and are almost useless in determining the cause of dizziness, he says. It seems, in the end, the best options are to have doctors be more careful and have more time with patients, but it is a serious problem and addressing it will be critical for increased medical safety.
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