Institute of Medicine Report Diagnostic Errors Gain Too Little Attention

Unfortunately, there are too many medical or hospital related errors that have injured or killed patients in the United States. According to a recent study by the Institute of Medicine, “Most people will experience at least one wrong or delayed diagnosis at some point in their lives, a blind spot in modern medicine that can have devastating consequences.” The institute’s report calls for urgent changes in many areas of health care. According to the report, the most significant change is that patients become central to a solution, said Dr. John Ball of the American College of Physicians. He chaired the Institute of Medicine committee.

The report indicates that medical providers must take patients’ complaints more seriously and make sure that the patient receives copies of test results and other records to encourage patients to ask, “Could it be something else?”

In other words, patients should be seeking other opinions from physicians to diagnose their ailments. This is a cultural shift. It could be the norm to finally get the right diagnosis or that the second opinion doctor calls the treating doctors to say it turned out to be this and not that. One of the most famous diagnostic errors occurred in 2014 when a Liberian man who was sick with Ebola initially was misdiagnosed in a Dallas emergency room as having sinusitis. The man returned two days later and eventually died.

The misdiagnosis of patients does not usually make such big headlines. The Institute of Medicine was told of a woman who went to an emergency room with heart attack symptoms only to be misdiagnosed with acid reflux. She was criticized for questioning the doctor’s diagnosis. By the time she returned to the hospital for treatment, she had suffered serious heart damage.

Many times, patients do not even know that they have been misdiagnosed. A very common misdiagnosis is that of cancer. The delay in correctly diagnosing and treating cancer at an early stage can be deadly.

According to the Institute of Medicine report, there is no good count of diagnostic errors or how often they lead to serious consequences or death. It did cite one conservative estimate that 5% of adults who seek outpatient care each year experience a diagnostic error. Diagnostic errors make up the leading type of malpractice claims that result in settlements or jury verdicts. Misdiagnosis is twice as likely to cause death than other medical negligence claims.

The prestigious Institute of Medicine can take credit for a revolution in health quality improvement back in 1999 when it estimated that between 44,000 and 98,000 people a year die as a result of preventable medical mistakes in hospitals.

In the following 16 years, the focus has been on hospital infections and medication errors rather than on diagnostic errors. Those errors are not part of standard medical reporting. In Cook County for example, the Cook County coroner would not necessarily be called to conduct an autopsy unless there was something peculiar, criminal or suspicious about the death.

In Kreisman Law Offices practice, more individuals are ordering private autopsies in cases of the death of a family member where the cause is questionable or unknown.

In one case cited by the Institute of Medicine, a patient was told that a dangerous case of anemia was due to stomach ulcer; however, treatment didn’t help and the hospital’s specialist discounted other symptoms. Eight months had passed before it was found that the patient had advanced kidney cancer. Luckily the woman survived. Later she found that the health records showing a pathology report had all but ruled out an ulcer during that first visit. This woman is now an advocate who tells people to get all their records immediately so they know what to ask the medical providers.

In practice, I would tell any potential client that he or she should retrieve medical records, hospital records and make a list of questions to ask and also bring a close friend or family member to any physician meeting to discuss diagnosis and treatment plans.

“This is not about blame. It’s about understanding how errors arise and what we can do to prevent them,” said Dr. Mark Graber of the Society to Improve Diagnosis in Medicine, which according to the Associated Press article on this subject, was what prompted the Institute of Medicine’s study. Misdiagnosis can be caused by many things, including hurried visits, poor communication with patients, misreading or misplacing x-rays, diagnostics and lab tests, electronic health records that cannot be readily shared, even recent experiences that color doctor’s thinking so they get stuck on one possibility rather than ruling out the most deadly possible cause of the patient’s symptoms.

There is now a new technologically advanced tool that doctors can use to correctly diagnose patient’s ailments. Technology tools can be used to assist physicians in making better and more accurate diagnosis. The Associated Press article, written by Laura Neergaard, a medical writer, said technology in medicine is like the computer that helps a pilot land an airplane. In other words, the computer tool would help a doctor think about all the possible and correct diagnoses that relate to the symptoms in real time. One such software program is called VisualDx where it was indicated that a medical malpractice insurer is offering insurance premium discounts to doctors who use this software program.

There is no question that patients seeking medical care for ailments, illnesses and injuries need to be proactive. The more questions asked, the more likely it is that doctors, medical providers and medical assistants will correctly and appropriately treat patients making the correct and early diagnoses.

Kreisman Law Offices has been handling medical malpractice cases, birth trauma injury cases, nursing home abuse cases and hospital negligence cases for individuals and families who have been injured or killed by the negligence of a medical provider for more than 38 years, in and around Chicago, Cook County and surrounding areas, including Westchester, Palos Hills, Orland Park, Midlothian, Steger, Glencoe, Buffalo Grove, Vernon Hills and Elk Grove Village, Ill.

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