Majority of ER Malpractice is Missed Diagnoses Which Leads to Serious Patient Injury and Death

Posted by Catherine D. Bertram, Esquire and Salvatore J. Zambri, Esquire

The U.S. Agency for Healthcare Research and Quality supported a study of 122 closed malpractice claims by Allen Kachalia, M.D., J.D., Tejal K. Gandhi, M.D., M.P.H., Ann Louise Puopolo, B.S.N., R.N., and others, the results were published in the February 2007 Annals of Emergency Medicine 49(2).  That study has been available for more than two years.   Unfortunately, we continue to see these sames types of errors in the cases we have at Regan Zambri & Long.  As set forth below in the AHRQ summary,  a majority of the ER malpractice cases that were reviewed involve  failure to order appropriate test and consults or failure to perform an adequate examination of the patient. 

According to the government study, "65% of the cases involved missed emergency department (ED) diagnoses that harmed patients. Nearly half (48% ) of these missed diagnoses were associated with serious harm, and 39 percent resulted in death. The leading breakdowns in the diagnostic process were failure to order an appropriate diagnostic test (58 percent of errors), failure to perform an adequate medical history or physical examination (42 percent), incorrect interpretation of a diagnostic test (37 percent), and failure to order an appropriate consultation (33 percent).  The cause of malpractice was complex.  A majority of cases involved multiple breakdowns in the diagnostic process, several contributing factors, and more than one provider. The most common contributing factors were mistakes in judgment (87 percent of missed diagnoses), lack of technical competence or knowledge (58 percent), and lapses in vigilance or memory (41 percent).

These cognitive factors operated alone in one-third of missed diagnoses; in two-thirds of cases other factors also contributed to the missed diagnoses. Other leading contributing factors to missed diagnoses included patient-related factors (34 percent), lack of appropriate ED staff supervision (30 percent), inadequate handoffs of patients to new staffers (24 percent), and excessive workload (23 percent)."

We have extensive experience litigating cases involving emergency room malpractice.  The outcomes can be tragic and sometimes, even deadly.   It is critical to have the records evaluated by a board-certified emergency medicine physician in order to determine if the national standard of care was breached and if the error caused serious injury or death to the patient.  At Regan Zambri & Long, we have relationships with nationally known experts in Emergency Medicine who will review the case and give us the answers you need to determine if medical error was involved.    Please contact us by clicking here or call 202-463-3030 for a consultation. 

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