Pop Quiz: Malpractice claims

Posted by Sten Westgard, MS

Can you guess which of these categories is the leading source of successful malpractice claims?

• Surgical mishaps
• Obstetrical problems
• Medication errors
• Anesthesia disasters
• Diagnostic errors
• Treatment errors
• Something else entirely?

The answer, after the jump...

As it turns out, according to a new study in BMJ Quality and Safety, the leading cause is

• Diagnostics Errors (29% of successful malpractice claims)

Not only are diagnostic errors the leading cause of successful malpratice claims, they also account for 35% of the total money paid out, and these errors are responsible for 39% of malpractice-related deaths.

Should this surprise us? Not really. Diagnosis happens at the very beginning of the patient treatment, so an error there has consequences that can compound and multiply over time. If you get the wrong diagnosis, either the wrong treatment could be given to you, or you might not be treated at all, both outcomes which can have extreme impacts to health.

By one estimate, missed diagnoses are killing 40,000 to 80,000 Americans each year. David E. Newman-Toker, a neurologist at Johns Hopkins University School of Medicine conducted the study, along with Ali S Saber Tehrani, of 350,000 successful malpractice allegations that span the years between 1986 and 2010. His conclusion?

"Diagnostic errors are the most common, the most costly and the most deadly of all medical errors."

For the laboratory, it's another sign that we have a vital role to play - one that is probably unappreciated. Laboratory testing contributes greatly to the decisions and diagnoses of clinicians. If we can step up our game, we can make a big impact on one of the biggest problems. The inflation-adjusted 25-year sum of diagnosis-related malpractice payments was $38.8 billion. Even in healthcare terms, that's a big number.

Here's the news story that discusses the scientific study:

• David Brown, "Diagnostic errors are leading cause of successful malpractice claims", Washington Post, April 22, 2013.

Here's the actual study itself:

• 25-Year summary of US malpractice claims for diagnostic errors 1986-2010: an analysis from the National Practitioner Data Bank, Ali S Saber Tehrani, HeeWon Lee, Simon C Mathews, Andrew Shore, Martin A Makary, Peter J Pronovost, Dave E Newman-Toker, BMJ Quality and Safety in Health Care Published Online First April 22, 2013