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Diagnosis Errors

Incorrect diagnosis or treatment can lead to serious complications and even death.  Both clinical judgment and communication by health care providers, including physicians and nurses, can play a significant role in preventing delays in diagnosis and treatment errors.

According to a study of one hundred diagnosis errors published in the Archives of Internal Medicine (July 2005, p 1493-1499), the causes of error fell into three categories: ‘no fault’, system-related and cognitive.  Faulty or inadequate knowledge was uncommon. The most common system-related factors involved problems with policies and procedures, inefficient processes, teamwork and communication. The most common cognitive problems involved faulty synthesis of information such as misjudging the salience of findings or faulty perceptions.  Common diagnostic errors included delay in diagnosis, failure to employ indicated tests, use of outmoded tests or therapy, and failure to act on the results of monitoring or testing.

Both diagnosis and treatment failures can result in serious injuries or death. Examples include failure to diagnosis and treat a heart attack, ruptured appendix, life-threatening infection, hemorrhage, brain injury, or symptoms of organ dysfunction. Diagnosis and/or treatment failures can result in prolonged hospitalization, disability and death. In such cases, an extensive review of the medical records is recommended to determine whether clinical judgment and communication played a role in delay in diagnosis or treatment errors.

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