[MOL] Medical Errors [01304] Medicine On Line

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[MOL] 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


  • 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 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.


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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