As the year draws to a close, we pause to take a look back at the major headlines and developments in the field of medical malpractice.
"Big 3" Account for Majority of Serious Medical Malpractice
A report out of Johns Hopkins Misdiagnoses released in 2019 found that the "big three" conditions (cancers, cardiovascular events, and infections) comprise nearly 3/4 (74%) of all serious harms from diagnostic errors. The study also found that 34% of malpractice cases for death or permanent disability began with an erroneous or delayed diagnosis, making it the biggest cause of serious harm among medical errors. The most frequent infection in misdiagnosis cases was sepsis, the most frequent vascular event was stroke, and the most frequently misdiagnosed cancer was lung cancer.
Opioid-Related Civil and Criminal Action
States across the country have started to take action against pharmaceutical companies who aggressively promoted their addictive drugs, often via misleading marketing practices. In August, Oklahoma judge ordered Johnson & Johnson and its subsidiaries to pay $572 million to deal with the financial impact the opioid crisis has had in the state. Opioid overdoses killed more than 4,600 people in the state of Oklahoma from 2007 to 2017, and the state has estimated it will take $17.5 billion over 30 years to abate the crisis. The companies have appealed the verdict. The following month, Texas announced a suit against Johnson & Johnson.
Law enforcement have also gone after individuals who played a part in the opioid crisis in order to turn a profit. This fall, federal prosecutors announced that they were filing charges against 11 doctors for unlawfully distributing opioids as part of a large-scale pill mill operation. The operation involved doctors from various specialties, including a family physician, a coroner, and a psychiatrist, all working in concert to profit from addiction. All were practicing in the Appalachian region, an area of the United States hit particularly hard by the opioid crisis.
Bias in Medicine Presents Serious Risk
When doctors have an unconscious bias, it can drastically affect health outcomes. This year, we discussed the individual and systematic biases against certain groups and the resultant effects on healthcare. Biases against women result in serious misdiagnoses. For example, heart attacks often go misdiagnosed in women because doctors have almost exclusively studied the presentation of a heart attack in male patients, despite the fact that female patients can present quite differently. Patients of color also face a multitude of negative outcomes as a result of bias. One study found black patients were 34% less likely to be prescribed opioids for pain than white patients with similar conditions.
We also explored research that found that many doctors and medical students have a bias against LGBTQ patients, which is affected by the frequency with which the students/doctors had interactions with LGBTQ individuals. Many of these studies suggested interventions that may help minimize bias, including increasing exposure to diverse groups while in medical school.