Diagnostic Errors Common, Costly, and Harmful

John Commins, for HealthLeaders Media , April 23, 2013

Wrong site surgeries and medication mishaps get all the gory malpractice headlines, but diagnostic errors are a larger, deadlier, and costlie r problem, according to a study released Monday by Johns Hopkins researchers.

"We have said repeatedly that the fundamental premise is if you don't have the diagnosis right you can't possibly get the treatment right unless occasionally you get lucky," says David E. Newman-Toker, MD, an associate professor of neurology at the Johns Hopkins University School of Medicine and leader of the study being published online in BMJ Quality and Safety.

"The correct premise is that correct therapy begins with correct diagnosis. Unfortunately the entire medical profession operates under the collective delusion that diagnoses are almost always right," Newman-Tucker says. "There are all kinds of things we track in the hospitals; quality measures of one kind or another. But nobody is tracking whether or not their diagnoses are right. It's either ironic or scary but it's not good."

The Johns Hopkins researchers reviewed 350,706 malpractice claim payouts between 1986 and 2010 and found that diagnostic errors accounted for 28.6% of the claims, the most severe patient harm, and punitive payouts that amounted to $38.8 billion.

The study examined only a subset of claims that prompted a malpractice payout, but the researchers estimated that between 80,000 to 160,000 patients suffer misdiagnoses-related, potentially preventable, significant permanent injury or death annually across the nation.

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2 comments on "Diagnostic Errors Common, Costly, and Harmful"

Marcia C (11/30/2013 at 3:55 PM)
11.30.13 Kaiser failed to treat me for a deadly infection Klebsiella Pneumoniae for 3.5 months despite my pleas of urgency, frequency and pain. I had to demand a referral to a urologist and another lab test with culture. Docs thought I had female "overactive bladder syndrome" and referred me to pelvic floor physical therapy and Kaiser gave me a discount on "glide and silk creams" and I was told to lie on two little balls and relax my psoas muscles. One error after another resulted in recently 10 days of hospitalization for sepsis, kidney issue and a pulmonary embolus from PICC line. I almost died. Terrible experience

WrongDiagnosis (4/23/2013 at 5:14 PM)
I had a wrong diagnosis at Kaiser and had to get the correct diagnosis out of system, and then fight Kaiser to have them treat me. I later spoke with a doctor working on the EHR system at Kaiser. They don't have a diagnosis area in it, so doctors have to read through the previous doctors' notes without any sort of summary of what has been ruled out. I would suggest for serious cases there is a diagnosis "tab" in the EHR. This is the model of our country's EHR system; and thousands will be harmed by it. This is a serious issue in medicine and must be addressed. I lost a year of my life, I guess I'm lucky I didn't die.




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