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Health & Fitness

Misdiagnosis Is A Major Public Health Problem

Medical errors can happen anywhere in the health care spectrum and varied forms. Recent studies show that errors in diagnosis, although impactful on patient care, near more attention.

Medical errors can happen anywhere in the health care spectrum and take any of several forms. A patient can suffer a medical error in a hospital, clinic, surgery
center, doctor’s office, nursing home, pharmacy, or even in the patient’s
home.  A medical error can involve medicines, surgery, diagnosis, equipment or laboratory reports, and can happen during even the most routine tasks.  Although
errors in surgeries and prescribing medications have received substantial
attention in recent years to improve patient safety, it appears that less
attention has been paid to errors in diagnoses made in the doctor’s
office.  Studies show that each year misdiagnoses in primary care may put thousands of patients at risk of inappropriate patient care and poor patient outcomes, and directly contribute to increased health care costs.

            The results of a study by the Johns Hopkins University School of Medicine in Baltimore, Maryland, reveals that errors in diagnoses in the doctor’s office may contribute to more patient injuries and deaths than other medical errors.  Errors in diagnosis falls within one of three categories: wrong diagnosis (another diagnosis was made before the correct one), missed diagnosis (no diagnosis was ever made), or delayed diagnosis (sufficient information was available earlier).  A
study published in the Annals of Internal Medicine reveals that of 10,739
malpractice claims from the 2005 to 2009 in the National Practitioner Data
Bank, errors in diagnosis accounted for 45.9% of paid claims from outpatient
settings and 21.1% of paid claims from in-patient settings.  Researchers estimate that approximately 150,000 people per year are victims of misdiagnoses, and collectively describe these types of medical errors as a major public health problem. 

According to researchers from Johns Hopkins, most errors
in diagnoses cause moderate to severe harm to the patient, noting that in a study
of 190 patients who suffered diagnostic errors made during primary care visits,
36 patients had serious, permanent damage and 27 patients died.  In most instances, the misdiagnosed patient
was hospitalized or turned up back at the office or emergency room within two
(2) weeks of the initial visit or hospital visit, according to
researchers. 

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Researchers from Johns Hopkins also believe that diagnosis-related
claims, not surgical or medical errors, are the most costly of all malpractice
payouts in the United States.  One study
determined that 25% to 59% of medical malpractice claims are attributable to
errors in diagnosis.  According to a
recent study by Johns Hopkins, between 1986 and 2010, malpractice payouts in
the United States totaled $39 billion, of which 35% was directly attributable
to errors in diagnosis.  The study
revealed that errors in diagnosis were the leading cause of claims associated
with death and disability. Although most errors in diagnosis occurred in
out-patient settings, those errors that occurred while a patient was in a
hospital setting were more likely to be fatal, according to the study.  The researchers in this study believe that as
many as 160,000 claims, which caused permanent damage or death and were
attributable to errors in diagnosis, were preventable. 

Researchers explained
that one of the difficulties in making an accurate diagnosis is certain common
symptoms, such as stomach ache or shortness of breath, could be signs of a
range of illnesses, both serious and not. 
Notably, most of the missed diagnoses were traced back to the office
visit and the doctor not getting an accurate patient history, doing a full exam
or ordering the correct tests, according to study results.  Although the information from these studies
may undoubtedly lead to changes in how physicians are trained, as well as the
development of a better process for collecting data on errors in diagnosis, and
the increasing use of technology and better technology to reduce errors, patients
are not completely powerless.  It is important
for a patient to come to an office visit prepared to give their doctor all of
the relevant information about the nature and timing of their symptoms, a list
of prescribed medications taken regularly, a recitation of family medical
history, and dates of recent hospital stays and/or doctor visits. 

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Fabio A. Sciarrino, Esq., is an attorney who represents victims of personal
injuries and their families (www.fabio-law.com).
  Should
you have a legal issue, question or concern, contact the Law Office of Fabio A.
Sciarrino, L.L.C. at info@fabio-law.com
or 267-615-8090 to set up a consultation with an Attorney to discuss your
specific legal issue, question and concern. 

SOURCES: JAMA Internal Medicine, online February 25, 2013; BMJ Quality and
Safety, online April 22, 2013; Annals of Internal Medicine, online March 4,
2013.

DISCLAIMER:  The information presented in this article is
not, nor is it intended to be, legal and/or medical advice and is provided for
general informational purposes only. Furthermore, the contents of this article do
not establish an attorney-client relationship.  The Law Office of Fabio A. Sciarrino, LLC does
not in any way warrant or guarantee the accuracy or completeness of the
information, descriptions, statements, quotations, citations or other content
contained in this article. Based on the foregoing, you should not rely on the
information contained in this article as a substitute for consulting with a
qualified attorney and/or physician/health care provider.

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