Last month, a new study on emergency room malpractice came out and examines why ER doctors are sued so often in misdiagnosis suits. One of the top claims against emergency physicians was failure to diagnose, which was also a leading cause of patient injury.
The study was conducted by The Doctors Company, a large insurer in the healthcare industry. Their conclusions may be biased as their aim is to protect the healthcare industry, but the bare data is fascinating.
The Doctor’s Group studied 332 ER malpractice claims. Of those 332 cases, there were generally four types of claims:
Misdiagnosis, or diagnostic-related issues: 57%
- Improper Management of Treatment: 13%
- Improper Performance of Treatment or Procedure: 5%
- Failure to Order Medications: 3%
Clearly, misdiagnosis is the biggest issue. Misdiagnosis includes the failure to make a differential diagnosis and the failure to consider all available clinical information. Top physicians reviewed the data and concluded that inadequate patient assessment, to include not using available clinical information, found in 52% of cases, was the leading contributor in failure to diagnose cases. Other factors that were identified as contributing to patient injury included:
Patient factors, such as obesity, which could delay delivery of care due to lack of adequate equipment for treating or evaluating obese patients: 21%
- Communication errors, to include the failure to read the medical records: 17%
- Communication between patient/family and provider, to include inadequate follow-up instructions or other language barriers:13%
- Insufficient documentation, including inadequate documentation about clinical findings: 13%
- Staffing issues, to include workflow and workload concerns: 12%
Misdiagnosis is often compounded by miscommunication or other communication errors. Moreover, improper documentation could possibly be characterized as a communication error. The study notes that emergency room doctors face a wide range of clinical problems that increase risks and also underscores that it is critical to take regimented steps, such as completing a “thorough differential diagnosis for each patient.” The study concludes that emergency medicine doctors are “more prone to be sued for diagnosis-related issues than many other specialists, because they treat patients who are unknown to them and who have a broad range of clinical problems.” The study hopes that this information will help doctors “focus on specific quality measures that will reduce exposure to malpractice claims and improve patient care.”
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