Oct 8

Missed Diagnoses Leading Cause of Medical Malpractice Involving Primary Care Physicians


Prescription Errors Second Leading Cause

According to  a recent study, the leading cause of medical malpractice lawsuits involving primary care physicians is the failure to diagnose a disease.  The study found that between 26  and  63 percent of claims were related to missed diagnoses, primarily cancer and heart attacks in adults and meningitis in children.  The second most common reason for a lawsuit was medication errors.

The study is published in the journal BMJ Open and is  discussed in Rachel Rettner’s article posted on the Huffington Post.

BMJ Open notes, that, in adults, the commonest missed or delayed diagnoses were mainly:

    1. cancer (most commonly breast, colon, melanoma, lung and female genital tract);
    2. circulatory system (most commonly myocardial infarction); and
    3. Other frequently cited missed or delayed diagnoses included appendicitis, ectopic pregnancy and fractures.

In children, two studies reported meningitis, gastroenteritis, pneumonia, appendicitis, sepsis and malignancy as the commonest conditions resulting in claims.  Overall, the second commonest medical misadventure cited in malpractice claims was medication error ranging from 5.6% to 20% across included studies.  One report utilized in the BMJ Open study reported that prescribing error, inappropriate medication, drug administration errors, dispensing errors and adverse drug reactions are the commonest processes which result in a medication error.  Two studies reported medication classes cited in claims which included steroid preparations, antibiotics, anticoagulants, antidepressants and antipsychotics.  One study reviewed claims resulting from adverse drug events and found that 27% of primary care adverse drug events were preventable.  Seven studies reported the proportion of malpractice claims which were subsequently found to be as a result of negligent care. In one large US study which examined over 27,000 resolved family practitioner claims (1985–2008), only 31.9% resulted in payment.  The compensation awarded to claimants varied across studies. In the USA, a review of almost 5000 family practice malpractice claims reported mean payments of $253,739.69 and median payments of $119,389.20.

One of the take-aways from the study was that understanding malpractice suits can help doctors identify situations that may result in adverse events for patients, which, in turn, can improve medical care.  Ultimately that is the purpose of medical malpractice lawsuits — to improve patient care.



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