Johns Hopkins medical researchers have found that diagnostic errors accounted for the largest number of medical malpractice claims based on an analysis of 25 years of U.S. malpractice claim payouts.
“This is more evidence that diagnostic errors could easily be the biggest patient safety and medical malpractice problem in the United States,” according to David E. Newman-Toker, M.D., Ph.D., an associate professor of neurology at the Johns Hopkins University School of Medicine and leader of the study. JHU is based in Baltimore, Maryland. “There’s a lot more harm associated with diagnostic errors than we imagined,” he said.
The majority of diagnostic errors were missed diagnoses, rather than delayed or wrong ones. Researchers estimate the number of patients suffering misdiagnosis-related, potentially preventable, significant permanent injury or death annually in the United States ranges from 80,000 to 160,000.
The study looked only at those claims where malpractice payout occurred. Researchers found that of the 350,706 paid claims, diagnostic errors were the leading type (28.6%) and accounted for the highest proportion of total payments (35.2%). Diagnostic errors resulted in death or disability almost twice as often as other error categories.
Researchers also found that more diagnostic error claims were rooted in outpatient care than inpatient care, (68.8% vs. 31.2%) but inpatient diagnostic errors were more likely to be lethal (48.4% vs. 36.9%).
Newman-Toker analyzed medical malpractice payments data from the National Practitioner Data Bank, an electronic repository of all payments made on behalf of practitioners in the United States for malpractice settlements or judgments since 1986.
Diagnostic error is defined as a diagnosis that is missed, wrong or delayed.
“Overall, diagnostic errors have been underappreciated and under-recognized because they’re difficult to measure and keep track of owing to the frequent gap between the time the error occurs and when it’s detected,” Newman-Toker said. “These are frequent problems that have played second fiddle to medical and surgical errors, which are evident more immediately.”
He said experts have often downplayed the scope of diagnostic errors, not because they were unaware of the problem, but “because they were afraid to open up a can of worms they couldn’t close.”
The human toll of mistaken diagnoses is likely much greater than his team’s review showed, Newman-Toker said, because the data they used covered only those cases with the most severe consequences of diagnostic error. There are many others that occur daily that result in costly patient inconvenience and suffering, he said. One estimate suggests that when patients see a doctor for a new problem, the average diagnostic error rate may be as high as 15%.
The medical malpractice lawyers at Baltimore, Md.-based Belsky, Weinberg & Horowitz are knowledgeable in medicine and law and have the financial and academic resources to handle “failure to diagnose” and other medical malpractice cases. Call us at 410-234-0100 or email us for a free consultation and let us help you.