[MOL] Medical Errors [01304] Medicine On Line


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[MOL] Medical Errors



BE AWARE OF MEDICAL ERRORS

Medical errors are more common than the public realizes. A comprehensive report by the National Academy of Sciences1 (December 1999) revealed that between 45,000 and 98,000 Americans die each year as a direct result of many kinds of medical errors.

This report prompted President Clinton to sign an executive order on December 7, 1999, launching a major Federal initiative (Agency for Healthcare Research and Quality) to reduce medical errors and improve patient safety.2

THE DOCUMENTATION:

  • Up to 9.5% of surgical pathology cases received a major change in diagnosis leading to significant revisions in treatment and prognosis. This figure-published in the prestigious medical journal Cancer-- comes from a recent study (December 1999) at Johns Hopkins Hospital3.

  • A University of Utah Medical School survey4 (February 2000) found a significant biopsy diagnostic disagreement rate of 2% to 5%.

  • A review5 of surgical pathology cases found a major error rate of 1.2%.

  • Judging by medical malpractice claims6, breast cancer patients are the most likely to encounter errors in the detection and diagnosis of their disease.




THE CAUSES:

The Most Commonly Encountered Errors in Surgical Pathology (Biopsy) Diagnosis of Cancer include:

  • A mass that is actually benign (non-cancerous) is incorrectly called malignant (cancerous). Microscopic view of breast cancer.

  • A tumor that is really malignant is erroneously called benign.

  • A cancer (malignant tumor) is correctly identified but assigned an inaccurate classification (type) or grade (aggressiveness).

  • A cancerous lesion is missed (inadequately sampled) by the biopsy procedure.

  • A specimen-- which contains cancer-- is incompletely sampled or prepared by the pathology department, causing the cancer to be undetected by the pathologist.
The first three situations can be detected by a second opinion review of the microscopic (glass) slides. The last two scenarios, however, require an alert clinician to be suspicious of cancer.




THE IMPACT:

Errors in the Biopsy Diagnosis of Cancer can lead to:

  • Unnecessary or incorrect cancer treatment (surgery, chemotherapy, radiation) with serious complications or long-term disability when a benign lesion is incorrectly diagnosed as malignant.

  • A missed opportunity to treat a curable cancer-- especially when an early malignant lesion is incorrectly diagnosed as non-cancerous or inadequately sampled. Doctor examining hospitalized patient.

  • Unnecessary and costly medical expenses.

  • Avoidable pain and suffering.


 
 
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