Overview

It's a sobering reality. Patients frequently discover that their medical issue was misdiagnosed. You might know someone who has gone through it. Perhaps it was you. In other cases, the mistake is not significant and has no long-term consequences. In other circumstances, the consequence is either life-threatening or fatal.

Despite developments in contemporary medicine, the rate of misdiagnoses has not decreased in recent decades.

Definition of Misdiagnosis

Primary care provider's experience, knowledge, skills, and resources available to them are the main factors on which a correct diagnosis relies on. Usually, primary care providers deal with large numbers of patients on a daily basis, whose conditions are often not easy to diagnose due to potentially difficult clinical presentations. Due to the fact that primary care providers have limited experience with less common diseases and methods of testing, the process of diagnosis represents a high-risk zone, where they are prone to make errors, such as missing the diagnosis, making a delayed diagnosis, or to setting a completely wrong diagnosis.  

People entrust their health to medical experts on a daily basis. Their lives are on the line. In the vast majority of cases, surgeries are carried out with accuracy, medical judgment is sound, and the patient departs in better shape with the promise of a full recovery. These healthcare providers and the facilities where they work are said to have met the required standard of care.

When anything goes wrong, however, patients can suffer severe injuries that might haunt them for the rest of their lives — or even be deadly. Bertram Law Group specializes in representing patients who have been damaged in this way. We put our reputation on the line.

The types of misdiagnoses are multiple and complex as misdiagnosis occur due to a variety of factors. Misdiagnoses divide into three main categories of diagnoses:

• Those that are completely missed, for example, cancer is missed despite its symptoms (for example colon/rectal cancer missed as a diagnosis when a patient presents with blood in stools),
• Wrong, as patients are informed about one diagnosis when there is evidence of another
• Delayed, when abnormal test results that suggest the presence of cancer, but nobody promptly informs the patient or runs further investigations.

Diagnoses can often occur over time, rather than at a special point in time, including initial assessment, performing and interpreting diagnostic tests, follow-up and tracking of diagnostic information, referral-related communication and coordination, and patient behavior, adherence and engagement. And not surprisingly, diagnostic errors can occur at each of these points of the complex healthcare journey of the patient.

Studies performed in high-income countries suggest that annually, almost 5% of its adult citizen have experienced errors within the diagnostics they have been provided with. Based on this information, scientists consider that more than half of these misdiagnoses could lead to severe harm.  Moreover, there are strong reasons to believe that 5% of misdiagnoses out of all the patients in a high-income country is very underestimated and the rate of misdiagnoses in low-income countries might be way higher. 

Greater challenges arise in low and middle-income countries due to limited access to quality diagnosis testing facilities, a lack of qualified and well-trained primary care professionals or specialists, and limited medical record storage systems. These are factors that are considerably improving the higher rate of misdiagnosis in primary care throughout the lower income states.

Unfortunately, the extent of diagnostic errors applied to children is unknown. A survey of children's doctors in a high-income country found that more than half reported to make a misdiagnosis at least once or twice per month and recognized that they made harmful errors at least once or twice a year.

Worldwide, delays in cancer testing procedures have become normality as about 7% of abnormal test results are not communicated to patients in a timely manner, causing a tremendous delay in establishing the diagnosis. Moreover, a study made by The University of Texas at Houston – Memorial Hermann Center for Healthcare Quality, consisting of 190 cases of diagnostic errors found that misdiagnosis were commonly found in patients suffering from pneumonia (7%), decompensated congestive heart failure (7%), acute renal failure (5%), cancer (5%) and urinary tract infection (5%). Additionally, another study has identified that the most commonly diagnosis errors are involving infections, trauma, and malignant neoplasms.

Causes of Misdiagnoses

As we are all human, all aspects of the diagnostic process could be subjective and, therefore, vulnerable to error. Studies of misdiagnoses have gathered enough data to learn that each case that suffers from a diagnosis error has the causes in its roots. The causes can vary in each situation and can be multiple, but they usually include cognitive errors, such as failure to synthesize the available evidence correctly or failure to use physical examination or test data appropriately. 

In fact, there is enough available proof that cognitive errors can be identified in more than a half of the misdiagnosis's situations. Systems' flaws are as well responsible to the diagnoses high level of vulnerability against errors as a result of problems with communication or coordination of care, problems with the availability of medical record data, and insufficient access to specialists.

Another study has found out that throughout the high-income countries, the causes of misdiagnoses can vary. One of the causes could be the frequently processes breakdowns between the patient and the medic during clinical encounter (79%). The second most usual cause of diagnoses errors is represented by referral problems (20%), followed by patient-related factors (16%) and lack of follow-up and tracking of diagnostic information (15%). 

Moreover, the method of diagnostic testing could alter the performance and interpretation of the results (14%). More than 50% of all diagnostic errors involved more than one of the afore mentioned causes. The encounters of breakdowns between the patient and medical specialist are firstly related to inconstant history-taking (56%), examination (47%), or ordering diagnostic tests for further workup (57%).

The environment that leads to a misdiagnosis consists of multiple factors. The patients from the low-income social category have limited access to high quality primary care services due to lack of money, illiteracy, or the enforcement of travel restraints. Also, the highly specialized medical staff is concentrated in the more developed urban areas. Usually, there is a lack of specialized expertise within the rural areas and the less developed urban areas.

 Additionally, the unmotivated medical staff performs poorly. It is not willing to learn from mistakes and make use in future cases of bad experiences, it is not willing to communicate with the patients about their medical information and it is doing an overall superficial work.

Moreover, in some countries, the culture is also playing a role that might cause misdiagnosis, and healthcare inequalities may arise depending on the social and economic status of patients, their gender, religion, sexual preference.

According to studies, doctors spend 10 to 15 minutes with each of their patients during sessions on average. This is frequently the consequence of excessive demand for care and the necessity to move on to other patients, rather than because doctors don't care about their patients.

Unfortunately, 15 minutes is insufficient time to discuss all of a patient's symptoms and concerns, obtain a thorough picture of their medical history, examine test findings, and make an accurate diagnosis.

As a result, doctors' inability to spend adequate time with patients frequently contributes to diagnostic mistakes. If patients do not return to the same doctor (for example, because they were sent to a new specialist), the cycle might begin again, with correct diagnoses being delayed once again.

In many circumstances, patients do not visit the same doctor throughout their treatment. This might be because they are sent to other specialists or because they move doctors. In other circumstances, doctors may simply delegate follow-up to patients, instructing them to contact them if anything changes.

Statistics in the European Union

The statistics in the European Union show an unwanted reality, almost a quarter of its citizen (23%) have been directly affected by a medical error personally or another member of their family. 18% of these persons state that they or their family members have been involved into a serious medical error in a hospital, while another 11% indicate that they been prescribed with the wrong medication. In general, it was reported that incidents in hospitals are more common than incidents of medication errors in primary care or pharmacies, although these might as well have a serious effect on the health and wellbeing of patients.  

The countries where hospital incidents are more prone to occur are Latvia (32%), Denmark (29%), and Poland (28%), while the countries where prescribed medication errors are more frequent are Latvia (23%) and Denmark (21%), Estonia and Malta (18% each).

Within the most accurate healthcare providers from Europe, Austria, Germany, and Hungary are having the least numbers of medical errors in hospitals (11%) and the lowest number of medical prescription errors (7%).

Statistics in the U.S.A

Annually, almost 12 million American people in need for outpatient medical care services are misdiagnosed, meaning that 1 out of 20 people has not been provided with the correct diagnosis.

Studies show that from the total of 12 million people misdiagnosed, between 10% and 20% are patients that present serious conditions, and 44% out of them have actually types of cancers that are misdiagnosed.  The most commonly misdiagnosed are Prostate cancer, Thyroid cancer, and Breast cancer. Moreover, 28% of the misdiagnoses are life-threatening or, even, life-altering and can lead to unnecessary treatments, increased costs, physical and emotional stress, and in worst case scenarios even death.

In the United States of America, the most common causes of misdiagnosis consist of scans that were interpreted by a general radiologist instead of a subspecialist; mandatory follow-up tests were not ordered by the physician or errors made by a doctor in interpreting test results.

Also, in the U.S.A, out of the total of patients that seek for a second opinion 66% get their diagnosis redefined, 21% get their diagnoses completely changed and only 12% manages to confirm the first diagnosis.

Which Diagnoses are Most Likely to be Misdiagnosed?

What are the most commonly misdiagnosed conditions?

• Stroke
• Irritable bowel syndrome (IBS)
• Carpal tunnel syndrome
• Systemic lupus
• Lyme disease
• Multiple sclerosis (MS)
• Various forms of cancer, heart attacks (especially in women), appendicitis, diabetes, Parkinson’s disease, and pulmonary embolism are among other commonly misdiagnosed conditions.

How Deadly are Misdiagnoses?

According to recent research, 40,500 patients who join a critical care unit each year will die as a result of a misdiagnosis. Every year, up to 80,000 individuals die as a result of complications caused by misdiagnosis.

Even if it does not prove deadly, a misdiagnosis can have major health effects. It can cause a delay in healing and may necessitate hazardous therapy. It can also be expensive for the patient, the physician, and the facility where the care was given.

What’s the Difference Between Misdiagnosis and Missed Diagnosis?

Both sound remarkably identical, and they can cause major complications for a patient. Medical misconduct can include both misdiagnosis and missing diagnoses. However, there are some significant differences between the two words.

A misdiagnosis occurs when a patient with one medical condition is mistakenly diagnosed with a disease that they do not have. A youthful stroke patient being diagnosed with migraine, vertigo, or alcohol intoxication; or an elderly patient experiencing a heart attack being sent home from the emergency hospital with a diagnosis of indigestion and a bottle of antacid.

A misdiagnosis causes some frustration as well as the waste of time and money. In the worst-case situation, treating the erroneous disease might make the patient worse or kill them, or it could postpone identification of the genuine ailment until it is too late to treat. In certain circumstances, the misdiagnosed condition's treatment is the polar opposite of the true sickness, implying that the patient would have been better off not seeing the doctor at all.

A doctor may misdiagnose a patient if he or she fails to obtain a complete medical history, orders tests that are not suggested by the patient's symptoms, or misreads test findings. 

What to Do if You Have Experienced a Misdiagnosis or Missed Diagnosis?

Mistakes and missed diagnoses are not unavoidable in the diagnostic procedure. While medical personnel are human people who, like the rest of us, make inevitable mistakes, many occurrences of misdiagnosis or failure to diagnose are the consequence of medical negligence.

If a doctor misdiagnosed you or failed to diagnose you with an illness you actually have, you may be entitled to compensation for the money you spent on the wrong treatment, your agony and suffering, and the health harm you suffered as a result of not receiving the proper diagnosis when you needed it.

Unfortunately, the time to submit a claim on behalf of yourself or a loved one who died as a result of a mistake or missing diagnosis is limited. Consult an expert medical malpractice attorney in Oregon to see if you have a valid claim.

When to Ask for a Second Opinion?

You have the right to seek a second opinion at any time. The initial doctor's diagnosis may not make you feel secure or comfortable. You might simply want to double-check. This is standard procedure.

The second doctor may have a different point of view. The second doctor, especially if he or she is a specialist, may see something that the first doctor did not. A second opinion that differs from the first might indicate a misdiagnosis. You might wish to seek a second opinion. If the therapy you've been recommended comes with a lot of hazards, this could be a good idea.

Although not all patients need second views, directing them to specialists to confirm diagnoses can preserve their health and save money, according to the study. Unfortunately, in order to keep costs down, some health insurance will not fund second opinions from specialists outside their networks. 

Can Misdiagnoses be Prevented?

Experts are still arguing how many misdiagnoses there are and how many of them may be avoided. Misdiagnosis affects 5% of US people, or 12 million patients every year. Many of these mistakes are regarded to be minor, but some do result in major consequences and even death.

Serious misdiagnoses, such as failing to diagnose a heart attack, stroke, or cancer, harm 80,000-160,000 individuals each year, according to one research, while 40,000-80,000 patients per year die as a result of misdiagnoses.

Physicians tend to overestimate the number of misdiagnoses. A study of almost 6400 clinicians, nearly three-quarters of whom were doctors, was conducted on diagnostic mistakes. Only around half of those polled claimed they encountered a misdiagnosis at least once a month in their workplace - a far lower percentage than the 5% of all diagnoses reported, and more in line with estimates of major misdiagnoses.

Furthermore, the doctors doubted that many misdiagnoses could be avoided. Only 8% claimed errors were "always" preventable, while over 90% agreeing that they were "often" preventable. They were also unconvinced that a long-term effort would reduce misdiagnoses: sixteen percent were extremely sure, 67 percent were moderately confident, and seventeen percent were not confidence.

Conclusion

A misdiagnosis is a diagnosis of an illness or condition that is wrong. It's decision that a patient has or does not have a specific ailment or condition when in reality they do or do not.

Maybe, percentages are not very suggestive for portraying the real situation and the population is not aware of the effects a misdiagnosis can have on a patient. But statistics are able to highlight that the strategies created to mitigate the medical errors risks in the European Union alone would prevent more than 750.000 patients from harmful and health-alternating medical errors per year, resulting in 3.2 million fewer days of hospitalization, 260.000 fewer incidents of permanent disability, and 95.000 fewer deaths per year.