As many as 7.4 million patients are misdiagnosed in U.S. emergency departments each year, according to a new report published by the Department of Health and Human Services’ Agency for Healthcare Research and Quality.
The DHHS report – Diagnostic Errors in the Emergency Department: A Systematic Review – provides a comprehensive view of diagnostic errors in U.S. emergency departments. According to the report, overall diagnostic accuracy in EDs is relatively high, but a significant number of patients receive incorrect diagnoses – and some suffer adverse outcomes as a result.
Some key findings from the report:
- Of the roughly 130 million emergency department visits each year in the U.S., an estimated 7.4 million patients (5.7%) are misdiagnosed.
- As many as 2.6 million patients (2%) suffer an adverse event because of their misdiagnosis
- Roughly 370,000 (0.3%) patients suffer serious harms from diagnostic errors.
To put these numbers in perspective, the report notes that an average emergency department with 25,000 annual visits would have over 1,400 diagnostic errors, 500 diagnostic adverse events, and 75 serious harms, including 50 deaths.
Commonly Misdiagnosed Conditions in the ER
According to the report, five conditions account for 39% of serious misdiagnosis-related harms, and the top 15 conditions account for 68%. The five most misdiagnosed conditions in the emergency room are:
- Stroke
- Myocardial infarction (heart attack)
- Aortic aneurysm / dissection
- Spinal cord compression / injury
- Venous thromboembolism
Researchers also noted that among these conditions, the diagnostic error rate can vary widely. Myocardial infarction, for example, is misdiagnosed in 1.5% of cases while spinal abscess is misdiagnosed in 56% of cases. The other 13 conditions are misdiagnosed at rates between 10% and 36%. Stroke, the most serious harm-producing condition, is missed approximately 17% of the time, researchers estimate.
Causes of Diagnostic Errors in the ER
In its review of data, the report drills down into the causes of ER errors.
It notes that variations in error rates across demographics reveal some issues – failures to diagnose stroke, for example, are more common among younger patients, while missed appendicitis is more common in older patients. Further, the report found that certain nonspecific or atypical symptoms can increase the likelihood of misdiagnoses. For stroke, dizziness or vertigo increases the odds of misdiagnosis 14-fold over motor symptoms – patients with dizziness and vertigo are missed initially 40% of the time. In fact, nonspecific, mild, transient, or “atypical” symptoms were the strongest and most consistent predictors or ER diagnostic errors.
The report also found that the root causes of diagnostic errors in the ER mostly stemmed from “cognitive errors linked to the process of bedside diagnosis.” These are the types of errors frequently cited in medical malpractice claims, such as failures involving clinical assessment, reasoning, or decision making.
Emergency Room Errors and Medical Malpractice
In addition to providing insight that can help emergency departments and practitioners implement solutions to prevent injuries and save lives, this report highlights the fact-specific nature of addressing medical emergencies in real time. And just as diagnostic error rates can be different depending on various factors, so too can the standard of care and the threshold for malpractice.
As a firm that’s earned national recognition litigating complex medical malpractice cases, our team at The Becker Law Firm knows it can be difficult for patients and families to assess when issues of emergency room errors, misdiagnoses, and failures to diagnose constitute medical malpractice. It’s why we leverage our extensive experience, the insight of award-winning attorneys, and input from staff with medical backgrounds to evaluate potential cases and help clients understand their rights and options.
If you have questions about an emergency room error and whether care provided to you or a loved one failed to meet the accepted standard, we want to help. Call (440) 252-4399 or contact us online for a FREE consultation.