Diagnostic errors lead to malpractice claims

Diagnostic errors account for the greatest proportion of total payments on malpractice claims in the past 25 years, a recent study indicates.

Analyzing 350,706 paid malpractice claims from the National Practitioner Bank from 1986 to 2010, investigators with Johns Hopkins University School of Medicine, Baltimore, described the error type, outcome severity and payments, according to the abstract. Diagnostic errors accounted for 28.6 percent of all paid claims, and had the highest proportion of total payments, at 35.2 percent.

Death, significant permanent injury and minor and major permanent injury were the most frequent outcomes of claims.

There were more diagnostic error claims for outpatient than inpatient cases (68.8 versus 31.2 percent). Inpatient diagnostic errors, however, were more likely to be lethal, at 48.4 versus 36.9 percent.

Adjusting for inflation, the 25-year sum of diagnosis-related payments was $38.8 billion. The median per-claim payout was $213,250; the mean payout was $386,849.

“We found roughly equal numbers of lethal and nonlethal errors in our analysis, suggesting that the public health burden of diagnostic errors could be twice that previously estimated,” the study authors concluded. “Healthcare stakeholders should consider diagnostic safety a critical health policy issue.”

The study was published online April 22 in BMJ Quality & Safety.