Lawyers who handle or investigate medical malpractice cases will often tell you that there isn’t usually just one mistake in a malpractice case. I think that you see a series of mistakes that many times build on one another.
In a study published in October in Annals of Internal Medicine,
found that 30 percent of missed, late, or wrong diagnoses resulted in death, and over 50 percent of the medical errors happened in cancer cases.
The study went on to look at non-emergency medical malpractice claims. This is where the study discussed some of the causes of mistakes and also talked about what might be done about it.
The study examined the different causes of diagnostic errors and categorized the resulting degree of harm to patients by five categories, ranging from emotional trauma to major physical injury to death.
The report concluded that breakdowns occurred at multiple points in the diagnostic process, resulting in a missed or delayed diagnosis.
In many missed diagnoses, two or more physicians contributed to the mistake.
Co-author of the report and an Associate Professor of Law and Public Health at HSPH professor, David M. Studdert said that “cognitive errors play a large role” in these types of medical errors.
The study also recommended ways to improve the diagnostic process, suggesting that systems reducing reliance on doctor’s memory, such as electronic test result tracking systems, be implemented.
Studdert also said that, in certain situations, physicians should consider consulting a specialist in a relevant field to assist with a diagnosis.
While a patient’s wellness is primarily the doctor’s responsibility, “the patient’s role is critical,” Studdert added. Patients should be “active participants” in the diagnostic process.
“People should try and follow up their lab results” to make sure their tests are executed and properly evaluated, according to Thomas.
The point about depending on memory is important. Using some sort of recording system or electronic medical record system that backs up the doctor’s memory can be a great help. I was listening to NPR the other day and I heard a report about a pharmacy system where doctors pulled up a patient’s medical record on a palm type computer and then wrote the new prescription on the computer. The computer then immediately checked for any known conflicts between the patient’s current medications and what was being prescribed. A great tool to add to the doctor’s “toolbox” so to speak. This same tool also completely eliminated any need for the pharmacy to call the doctors office to decipher the handwriting on the prescription.
Article Source: The Harvard Crimson
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