Misdiagnosis & Late Diagnosis
Medical Errors and Misdiagnosis
The final report of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry released in 1998 identified medical errors as one of the four major challenges facing the nation in improving health care quality. Based on the recommendations of that report, President Clinton directed the establishment of the Quality Interagency Coordination Task Force (QuIC) to coordinate quality improvement activities in federal health care programs.
Types of Errors
The Institute of Medicine (IOM) defines a medical error as “the failure to complete a planned action as intended or the use of a wrong plan to achieve an aim.” An adverse event is defined as “an injury caused by medical management rather than by the underlying disease or condition of the patient.” For instance, the patient who receives an antibiotic to which he or she is known to be allergic, goes into anaphylactic shock and dies represents a preventable adverse event.
Most people believe that medical errors usually involve drugs such as a patient getting the wrong prescription or dosage, or mishandled surgeries such as amputation of the wrong limb. However, there are many other types of medical errors including:
Diagnostic error such as misdiagnosis leading to an incorrect choice of therapy, failure to use an indicated diagnostic test, misinterpretation of test results, and failure to act on abnormal results.
Equipment failure such as defibrillators with dead batteries or intravenous pumps whose valves are easily dislodged or bumped causing increased doses of medication over too short a period.
Infections such as post-surgical wound infections.
Blood transfusion-related injuries such as giving a patient the blood of the incorrect type.
Misinterpretation of other medical orders such as failing to give a patient a salt-free meal, as ordered by a physician.
Preventing Errors
Research clearly shows that the majority of medical errors can be prevented:
One of the landmark studies on medical errors indicated 70 percent of adverse events found in a review of 1,133 medical records were preventable.
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