Missed and Delayed Diagnoses Studied in the Ambulatory Care Setting
The most common errors made in ambulatory care settings involve a missed diagnosis of cancer. A study published in the Annals of Internal Medicine on October 3, 2006 found that, in a review of 181 closed malpractice claims, that the most common errors made in an ambulatory care setting involved a missed diagnosis of cancer – primarily breast cancer, colorectal cancer and skin cancer. The authors also reported that one-third of women with abnormal results on mammography or Pap smears do not receive follow up that is consistent with well-established guidelines. Other frequently missed diagnoses included infections, fractures and myocardial infarctions (heart attacks).
The study attributed the errors to breakdowns in the diagnostic process. The leading cause of the breakdowns, in descending order, were: the failure of the doctor to order an appropriate diagnostic test, the failure to create a proper follow-up plan, and, the failure to obtain an adequate history or to perform an adequate physical examination.
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