Journal article

Missed and delayed diagnoses in the ambulatory setting: A study of closed malpractice claims

Tejal K Gandhi, Allen Kachalia, Eric J Thomas, Ann Louise Puopolo, Catherine Yoon, Troyen A Brennan, David M Studdert

Annals of Internal Medicine | AMER COLL PHYSICIANS | Published : 2006

Abstract

BACKGROUND: Although missed and delayed diagnoses have become an important patient safety concern, they remain largely unstudied, especially in the outpatient setting. OBJECTIVE: To develop a framework for investigating missed and delayed diagnoses, advance understanding of their causes, and identify opportunities for prevention. DESIGN: Retrospective review of 307 closed malpractice claims in which patients alleged a missed or delayed diagnosis in the ambulatory setting. SETTING: 4 malpractice insurance companies. MEASUREMENTS: Diagnostic errors associated with adverse outcomes for patients, process breakdowns, and contributing factors. RESULTS: A total of 181 claims (59%) involved diagnost..

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