Posted by Bill Sandweg on 26 December 2022.
This may come as a shock to you but there are a lot of mistakes made in the emergency department that kill and seriously injure people. If you do what I do for a living, you already know this. If you are just a regular member of the public, this may be big news to you. Importantly, this is not just me saying there is a lot of medical malpractice in the emergency department. This is the federal government talking after a review of what has happened in ER’s over the last twenty years.
The Agency for Healthcare Research and Quality is the division of the Department of Health and Human Services which is charged with monitoring the quality of health care in the United States. It conducted a study of twenty years of reports concerning care in the emergency department and made some important findings. Here are some of the most important points.
About one in every 18 emergency department patients will be misdiagnosed. Fortunately, most of those misdiagnoses will not cause a serious injury but some will. One in every 50 emergency department patients will be harmed by the misdiagnosis and one in every 350 patients will suffer either permanent disability or death. Given that there are over 130 million emergency department visits each year, there are over 7 million people who are misdiagnosed, 2.6 million injured and 370,000 each year who are either permanently disabled or killed.
Some medical conditions are more commonly misdiagnosed than others. The top five most commonly misdiagnosed conditions are strokes, myocardial infarctions (heart attacks), aortic aneurysm/dissection, spinal cord compression/injury, and venous thromboembolism. These five account for about 40% of the most serious harms caused by misdiagnosis.
If you have classic signs for a condition, you are less likely to be misdiagnosed. The correct diagnosis is as clear as the nose on your face. On the other hand, if you have something less than a classic presentation or if your symptoms are coming and going, your chances for a misdiagnosis go up substantially. In malpractice trials involving misdiagnosis of an unusual problem, the defense lawyer will tell the jury that when a doctor hears hoofbeats, the doctor thinks about horses and not zebras. If your medical condition is an uncommon zebra condition, you are much more likely to be misdiagnosed.
The most common reason for a misdiagnosis was cognitive error by the health care provider. As in many other areas of life, once someone gets a thought in their head about what the problem might be, they begin looking for reasons which support their conclusion instead of keeping an open mind and considering all of the available evidence. This is where the emergency department doctor hears hoofbeats and starts thinking about horses instead of waiting till all the results are in to see if this time it just might be something other than a horse.
As usual, women and people of color can’t catch a break. Women and people of color are more frequently misdiagnosed than white males.
The rate of misdiagnosis varied greatly among hospitals. Teaching hospitals had the lowest rates of misdiagnosis, although the reason for that was not entirely clear. Some hospitals, on the other hand, were virtual malpractice factories with rates of misdiagnosis 100 times as high as the best hospitals in the study. It makes a difference where you go and information about hospital health care quality is available on line from the federal government.
If you go to the emergency department, are misdiagnosed, and suffer a serious injury, Don’t expect anyone to tell you that you have been the victim of malpractice. Don’t sleep on your rights. Get your case evaluated by an experienced and competent medical malpractice attorney. Most people who are injured in hospitals, never make a claim. They bear the burden of their injury by themselves instead of letting it be borne by the person responsible for causing it. Don’t be one of these people.