Emergency Room Diagnostic Errors

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Medical care in a hospital’s emergency room can be challenging given the serious conditions of many patients.  But not every decision or action made by ER healthcare workers is correct.  A new study revisited a serious medical error most commonly made in the emergency department: misdiagnosis.

The Doctors Company is a provider of medical malpractice insurance.  In June it released the findings of its study of mistakes made in hospital emergency rooms (“Emergency Department Process of Care Closed Claims Study: Focus on Diagnosis Case Types”). Researchers reviewed closed medical malpractice lawsuits between 2014 and June 2019.  All of the claims alleged some sort of misdiagnosis in emergency room care.

Researchers set out to compare their review to one conducted 10 years earlier in 2011 by another medical malpractice insurance provider, CRICO.  That study (“Annual Benchmarking Report Malpractice Risks in Emergency Medicine”) found that 8% of the closed medical malpractice lawsuits between 2006 and 2010 alleged medical errors in hospital emergency departments.

Failure to Diagnose is Common in the ER

The 2011 study also found that the medical error asserted in almost half of those lawsuits was for a failure to diagnose.  And 30% of the ER diagnostic errors led to the death of the patient.

The 2011 study determined that:

  • 41% of the emergency room misdiagnosis lawsuits asserted an inadequate assessment of the patient that led to a premature discharge
  • 39% of the lawsuits alleged an issue with the ordering of a medical test

Following misdiagnosis, the other medical errors most commonly asserted in the emergency room medical malpractice lawsuits related to:

  • Management of medical treatment
  • Medication administration
  • Surgical recommendation

Causes of Misdiagnosis in the Emergency Department

The 2021 study was narrower than the 2011 research, focusing solely on diagnostic errors made in emergency rooms.  Researchers noted that a variety of factors can lead to these mistakes:

  • Frequent distractions in the ER
  • Noisy medical device alarms
  • High patient volumes

The study identified a range of patient harm encompassed in the medical malpractice lawsuits, with the most serious labeled “High Severity.”   High severity injuries that occurred from ER diagnostic errors were classified as:

  • Permanent significant – deafness, loss of a limb, eye or lung
  • Permanent major – blindness, paraplegia, brain damage
  • Permanent grave – quadriplegia, severe brain injury
  • Death

Errors Made in the Process of Emergency Department Care

The study outlined the process of emergency department care.  Ordering diagnostic tests is one component; others are consult management, interpreting diagnostic tests and ongoing patient assessment.

As in the 2011 study, a failure to order diagnostic tests was a common error cited in the emergency department lawsuits, but in an even higher percentage.  This mistake was cited in 53% of the medical malpractice claims.  CT scans were identified as the ER test most commonly delayed or not ordered.

The next two steps in the ER care process that had the most errors asserted in the lawsuits were:

  • Consult management – 33% of the lawsuits
  • Ongoing patient assessment – 32% of the lawsuits

Failure or delays in obtaining medical consults most often occurred with ER patients suffering strokes or heart attacks.

The study notes that cognitive biases may account for diagnostic errors in the emergency department. To avoid this, the study recommends hospitals develop care protocols that encourage better ongoing assessments of patients and communication among care givers during the diagnostic process.

While emergency departments are often hectic, patients undergoing treatment in them still are owed a standard level of care.  When not provided, resulting preventable errors such as misdiagnosis too often have devastating consequences for patients and their families.

If you lost a loved one unexpectedly while receiving medical care in the emergency room or elsewhere, turn to a personal injury attorney experienced in conducting medical malpractice investigations.

The choice of a lawyer is an important decision that should not be based solely on advertisements.

Authored by Gray Ritter Graham, posted in Articles July 9, 2021

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