The advances in modern medicine over the last decade have been nothing short of life-changing. Advancements in technology and technique now allow us to live longer, healthier lives. However, in order for patients to take full advantage of all treatment modalities for a particular medical issue, a timely, correct diagnosis is essential. Unfortunately, all too often in the United States, errors are made in the early stages of a disease or injury which can ultimately affect a patient's prognosis.
Diagnostic Errors in the United States
It is difficult to know exactly how frequently diagnostic errors occur. Researchers have used a variety of methods, including studying autopsy examinations, as well as "secret shopper" style studies, in which real or simulated patients with classical presentations of common diseases are sent anonymously into real practice settings. Several research studies have estimated the rate of diagnostic error at about 13-15%.
Most Commonly Misdiagnosed Medical Conditions
Research published in Diagnosis in 2019 found that there are three medical conditions that are consistently involved in misdiagnosis cases in the US: cancer, vascular events, and infections. These conditions, taken together, represent 75% of medical malpractice cases with "high severity harms." High severity harms involve significant, severe health impacts to the patient. Of the "high severity harms" identified in this study, 53% of patients died.
Researchers have termed these conditions "The Big Three." The most commonly misdiagnosed of the three was cancer (37.8% of all misdiagnosis cases examined by researchers in this study), followed by vascular events (22.5% of cases), and infections (13.5%) 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.
Types of Diagnostic Errors in Philadelphia Medical Malpractice
Diagnostic error can take many forms, and many different types of providers may be involved in committing these errors. Below, we examine three of the most common types of diagnostic errors.
A misdiagnosis occurs when a physician or health care professional diagnosis a medical condition in the patient when a patient does in fact have a medical condition, but the diagnosis is for a condition other than the one the patient is actually suffering from. For example, a patient may visit his or her primary care doctor complaining of fatigue and body aches and receive a diagnosis of flu when the patient has truly been infected with Lyme disease.
Misdiagnosis poses several risks to the patient. To begin with, any delay in an accurate diagnosis of the actual medical issue can result in worsening of the prognosis of the actual underlying condition. Additionally, if the misdiagnosis results in treatment of a condition that is not present, the treatment itself could pose a threat to the patient's health. In one case that made headlines in 2019, a young woman from the UK was erroneously diagnosed with breast cancer and underwent unnecessary rounds of radiation and chemotherapy before the diagnostic error was discovered.
A delayed diagnosis is a sub-type of misdiagnosis. In a delayed diagnosis, a health care professional may eventually diagnose the correct underlying medical condition, after first either diagnosing the wrong condition or diagnosing no issue whatsoever. In the study of misdiagnosis cases in the United States cited above, researchers found that lung cancer was one of the most commonly misdiagnosed conditions. Lung cancer symptoms include persistent cough, shortness of breath, chest pain, and headaches, which are present in many other, less serious medical conditions.
This is especially troubling considering the fatality rate of lung cancer. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. It claims more lives each year than do colon, prostate, ovarian and breast cancers combined. Additionally, lung cancers are among the fastest-growing of all cancers, meaning that a delay in diagnosis can have a significant impact on the patient's prognosis (for example, if the diagnosis was missed while the cancer was present merely in the lung, but made once it had metastasized to other organs in the body).
Failure to Diagnose
Failure to diagnose can involve a case in which a physician fails to diagnose a medical condition altogether, or fails to diagnose complication(s) from an underlying medical condition. The patient may eventually seek a second opinion and obtain the correct diagnosis, obtain an accurate diagnosis as the result of needing emergency care, or may never receive an accurate diagnosis, and family members may learn of the underlying condition after receiving autopsy results.
Recent research has demonstrated that one area in which failure to diagnose was particularly widespread involved heart attacks in women. Many female patients did not present with acute chest pain and perspiration, which were thought of as "classic" heart attack symptoms (those that are more common in men). Instead, female patients reported more subtle symptoms, such as experiencing shortness of breath, extreme fatigue or even pressure in the upper back. Not only were these individual claims routinely dismissed by doctors, but the generally accepted assumption was that women did not have a significant risk for developing heart disease. Heart disease is the number one cause of death for women in the United States, and guidelines have been changed to recognize symptoms of heart attack and other vascular events which may present differently in male and female patients.
Providers Involved in The Diagnostic Process
There are a wide range of health care professionals who may play a role in a diagnostic error. One of the most represented types of providers in this group is the primary care physician. Many Americans choose to bring symptoms to the attention of their PCP first, before seeking out the services of a specialist. Also, many health insurance plans require subscribers to obtain a referral from a primary care doctor before visiting a specialist. Of the study of misdiagnosis cases cited above, roughly half of the cases involved primary care clinicians.
Many other providers can play a role in a diagnostic error, especially those who may be involved in interpreting test results and medical imaging. The other specialties mentioned in the study included cardiology, gastroenterology, and neurology, surgical specialties, and diagnostic services like radiology and pathology. However, this is by no means an exhaustive list. Diagnostic errors can be made by many providers and can be made at many different points along the treatment route.
Philadelphia Medical Malpractice Claims for Diagnostic Errors
Diagnostic errors can have repercussions not only on the ultimate prognosis of a patient but also on the financial health and stability of the patient and his or her family. These types of errors can result in unnecessary tests, imaging, surgeries, and other medical procedures. Any type of delay in obtaining the correct diagnosis can lead to the worsening of a medical condition, which often means additional treatment, and accompanying additional treatment costs. In addition to
The best way for a victim to obtain compensation for a diagnostic error is through filing a medical malpractice lawsuit. In fact, diagnostic errors represent one of the most common causes for filing such a claim. Medical malpractice is generally defined as when a health care provider fails to meet the applicable standard of care, and a patient is harmed as a result of this failure. The "standard of care" is generally defined as the level of care that a provider with a similar background would give under similar circumstances. For example, a first-year surgical resident would not be subject to the same standard which would be applied to an experienced attending surgeon with decades of practice. Also, the circumstances of treatment must be similar; medical testing results interpreted in a top-ranked hospital would not be considered similar circumstances to a quick diagnosis made by a doctor in the backcountry coming across an injured hiker.
It is also important to note that this action (or failure to act) must cause a measurable harm to a patient. For example, take a physician who meets with a patient reporting symptoms of persistent cough, fever, and chest pains. The physician diagnoses acute bronchitis brought on by a bacterial infection and prescribes the antibiotic amoxicillin. The patient was actually suffering from bacterial pneumonia, another lung condition which can also respond to antibiotics. If the patient eventually gets well despite the diagnostic error, there wouldn't be a measurable harm that could give rise to a claim of medical malpractice. To contrast, if a patient presents with complaints of persistent cough, chest pain, and headaches and is diagnosed with bronchitis, yet truly has lung cancer and isn't diagnosed until a year later, at which point the cancer has metastasized to distant organs, it is possible that this would be harm that could give rise to a viable claim of medical malpractice.
Philadelphia Medical Malpractice Attorneys
Diagnostic errors can have a devastating impact on a prognosis. However, it can be incredibly complicated to even determine if an error of this type occurred and to determine exactly when the error was made, and who was ultimately responsible. Our team has decades of legal experience and the extensive resources necessary to thoroughly investigate cases involving diagnostic error. Contact our team for a free consultation to discuss the specifics of your case.