Misdiagnosis most common cause of

Clinical Negligence Claims

Two studies published recently demonstrate that inaccurate or delayed diagnoses are a leading cause of Medical malpractice claims.

One study showed that in malpractice claims where the patient died or was seriously disabled, 34% of claims cited inaccurate or delayed diagnosis as the cause of the problem. Of those claims almost two thirds led to death or permanent disability.

The study also showed that claims as a result of diagnosis errors comprised 28% of all compensation payments.

The author of one of the studies said that “diagnostic errors are the most common, most catastrophic and most costly of medical errors.” The study based among other things of a review of tens of thousands of closed malpractice claims between 2006 and 2015 concluded that almost three quarters of claims arising from diagnostic errors were attributable to cancer, vascular events such as strokes or heart attacks and infections.

The study found that cancer was most likely to be misdiagnosed or missed in Outpatients Clinics and in Emergency Departments and in Hospital In-Patient settings vascular problems were most likely to be missed.

A second study focused specifically on malpractice claims arising from diagnosis errors at Hospital Emergency Departments. That study found that problems with diagnosis made up almost half of all malpractice claims arising from treatment in Emergency Departments and one third of total claims made. Essentially that Report said that the most common cause of claims arising from treatment in Emergency Departments was a failure to diagnose the problem properly. This is a particularly serious problem given that half of all In-Patient Hospital Admissions begin in the Emergency Department.

The study indicates that a major cause of the failure to diagnose the condition properly at the beginning was as a result of a failure to take a proper Patient History and to carry out a proper physical examination, incorrect or inadequate diagnostic decision making process and a failure to ensure that the patient evaluation continued throughout the care in the Hospital.

Both Reports make a series of recommendations as to how to improve matters. These include: -
1. Emergency Department should focus on patient history and physical examination.
2. Improvement in diagnostic decision making process.
3. Ensure that patient evaluation is ongoing throughout the episode of care.
4. Emergency Departments should develop a policy to require that specific elements of the patient’s and family’s medical history are documented.
5. After Triage is carried out in an Emergency Department patients left waiting should be checked after initial assessment to make sure that their condition has not changed.
6. When Emergency Room doctors are called away after a patient is initially stabilised procedures should be in place to ensure that the Medical Attendant to whom care is being transferred is given a proper brief.

If you require any further detail or advice, please contact John Reid in O’Rourke Reid
Dial: +353 1 240 1200
Email: jreid@orourkereid.com

This document is for information purposes only and does not purport to represent legal advice.  
© O’Rourke Reid 2019