Incorrect diagnosis of medical problems represents one of the most common reasons why patients are injured.

Incorrect diagnosis Errors Problems

Incorrect diagnosis errors are a risk for physicians, nurse practitioners and physicians assistants in ambulatory care. They represent a large percentage of medical malpractice settlements. The allegations are broadly divided into

• Failure to diagnose
• Delay in diagnosis
• Improper performance
• Failure to recognize a complication
• Wrong or misdiagnosis

In a study of over one thousand nurse practitioner-related cases recorded in the National Practitioner Data Bank, the top allegation was “diagnosis related”. In a previous blog, I shared the case of a woman who had a delay in diagnosis of breast cancer, with a tragic outcome.

According to Diedrich Healthcare, diagnosis-related allegations are also the single largest category of complaints against physicians. They represented 33% of the payouts for medical malpractice in 2013.

Test results assist not only with the diagnosis of conditions but with monitoring the effectiveness of treatment. Patients may be injured by delays in communicating test results, by switched or lost specimens, by missed or delayed tests, and by errors in patient follow up on test results.

The National Quality Forum Board identifies serious reportable events. Two are specifically related to the topic of laboratory results:

• Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen
• Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results.

Laboratory Errors
Laboratory test results errors reflect weaknesses in the ambulatory care system. It is often useful to question defendants about how the system of reporting laboratory results works now. This helps you identify where the process breaks down. Question providers about these areas:

• The protocol for reporting critical and normal test results – who does this, when does it happen
• Turnaround time for reporting results to the patient, and how is this different from normal versus abnormal results
• How results are reported to the patient – through a letter, a phone message or email

Electronic Medical Records
Electronic medical records may play a role in helping providers achieve the correct diagnosis. Many software programs are set to highlight critical or serious lab results, incorrect doses, incompatible medications and other clinical alerts. The software may be set up to remind providers of the need for cancer screening tests and to track test results. The ambulatory care staff all play a role in gathering information from patients and on behalf of patients to aid the providers in reaching the right diagnosis.

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