Email a Friend
Print ArticleInformation and Resources
This article is from the WebMD News Archive
When Doctors Err, Many to Blame
Oct. 2, 2006 -- Who is to blame when patients are injured by missed or delayed primary care diagnoses? The finger of blame points in many directions, a new study shows.
The study is one of the first to look at medical errors that happen not in hospitals, but in doctors' offices across the nation. It comes from medical-error researchers Tejal K. Gandhi, MD, MPH; David M. Studdert, ScD; and colleagues at Brigham and Women's Hospital in Boston.
Gandhi and colleagues looked at the medical and legal records for 181 malpractice claims for a missed diagnosis settled against primary care doctors. The harm was serious in 59% of the cases; 30% of the cases resulted in death.
The main findings:
- A missed cancercancer diagnosis -- particularly breast cancerbreast cancer -- was the most common error.
- Failure to order the appropriate test, seen in 55% of the cases, was the most common diagnostic breakdown.
- Failure to create a proper follow-up plan was the breakdown in 45% of the cases.
- Failure to get a proper history from a patient or to perform a proper physical exam was the breakdown in 42% of the cases.
- Incorrect interpretation of test results was the breakdown in 37% of the cases.
- The typical case had three different breakdowns.
In all of these cases, doctors made mistakes. They had failures of judgment (79% of cases); failures of vigilance or memory (59% of cases); too little knowledge (48% of cases); and failed properly to hand the case off to another doctor (20% of cases).
At least two doctors erred in 43% of the cases -- and at least three doctors were involved in 16% of the cases.
The study doesn't let patients off the hook. Nearly half the time, patients failed to provide their doctors with crucial information or missed appointments.
"The prospects for 'silver bullets' in this area seem remote," Gandhi and colleagues conclude. "Our findings are humbling, and they underscore the need for continuing efforts to develop the 'basic science' of error prevention in medicine, which remains in its infancy."
The study appears in the Oct. 3 issue of Annals of Internal Medicine.
del.icio.us
-
1
-
2
-
3
-
4
-
5
-
6
-
7
-
8
-
9
-
10
-
11
-
12
-
1
-
2
-
3
-
4
-
5
-
6
-
7
-
8
-
9
-
10
-
11
-
12
-
1
-
2
-
3
-
4
-
5
-
6
-
7
-
8
-
9
-
10
-
11
-
12
Boosting Your Breasts Without Implants
A breakthrough procedure gives women who want bigger breasts, but don’t like the idea of implant surgery, a new option.
Most Popular
