Physician errors are a factor in about 60% of medical malpractice claims that involved patients allegedly injured because of missed or delayed diagnoses, according to a study published on Monday in the Annals of Internal Medicine, the AP/Long Island Newsday reports.
For the study, researchers at Brigham and Women's Hospital in Boston reviewed 307 claims from four large malpractice insurers that were closed between 1984 and 2004, 181 of which involved alleged diagnostic errors that injured patients. Researchers ignored the outcomes of the claims. The majority of the claims involved cancer patients, 30% of whom died. Although most of the claims involved several factors, the study finds the major ones involved physician errors. According to the study:
- 100 claims involved failure to order appropriate diagnostic tests;
- 81 claims involved failure to establish a plan for appropriate follow-up care;
- 76 claims involved failure to obtain an adequate patient history or perform an adequate physical examination; and
- 67 claims involved improper interpretation of diagnostic tests.
The main factors that contributed to the physician errors included failures in judgment (79%), memory problems (59%), lack of knowledge (48%), patient-related issues (46%) and patient handoffs from other physicians (20%), the study finds. Tejal Gandhi, lead author of the study and director of patient safety at Brigham and Women's, said that the use of electronic health records, improved algorithms for patient evaluations and help from nurse practitioners to ensure patients receive appropriate follow-up care might help reduce the number of physician errors. "We think there could be tools to help physicians make these decisions better," Gandhi said. Steven Sorscher, an oncologist at Washington University Medical School in St. Louis, said, "It seemed like the bottom line was that the problems were problems that would occur less if a person was just very compulsive or very diligent. It highlights the fact that the causes of serious errors are often preventable" (Walters, AP/Long Island Newsday, 10/2).
The study is available online.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.