Diagnosis-related events are the single largest root cause of medical professional liability claims and 36 percent result in death, according to a new report from Boston-based medical liability insurer Coverys.
Here are eight things to know.
1. The report analyzes more than 10,000 closed medical professional liability claims at Coverys across between 2013 and 2017.
2. Diagnosis-related events accounted for 33 percent of all claims and 47 percent of indemnity payments. Over half — 53 percent — of diagnosis-related claims include risk management issues involving poor clinical decision making.
3. High severity cases make up 54 percent of diagnosis-related claims and 36 percent of diagnosis-related claims come from outpatient locations; 35 percent of diagnostic errors occur in non-emergency department outpatient settings, such as offices or clinics.
4. Only 24 percent of diagnosis-related claims take place in the emergency department and urgent care facilities.
5. The leading conditions involved in diagnosis-related claims are:
- Cancer: 27 percent
- Infection: 13 percent
- Cardiac/vascular conditions: 8 percent
- Fracture/dislocation: 5 percent
- Myocardial infarction: 4 percent
6. A third of diagnosis-related claims allege the clinical decision-making breakdown occurred due to failure during the evaluation of a patient. Testing is involved in more than half of all diagnosis-related medical professional liability claims, with failures in ordering, performing, receiving, transmitting and interpreting test results constituting more than half of diagnosis-related claims.
7. Nearly 84 percent of all adults and 93 percent of all children make a total of 125.7 million hospital outpatient and 884.7 million physician office visits every year in the U.S., and an estimated 10 to 20 percent of all diagnoses for these patients are inaccurate, according to report co-author Robert Hanscom, vice president of business analytics for Coverys.
8. To prevent errors in the evaluation process, providers should obtain a complete patient and family history, review history notes in the patient record and conduct a thorough exam.
Download the full report here.
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