Medical Errors in the ED: More Than Bad Judgment?

Most previous studies have looked at medical errors in the emergency department in the context of specific diagnoses or epidemiologic risk factors. In the current study, the authors sought to identify operational issues that contribute to ED diagnostic errors. They reviewed a random sample of 122 closed malpractice claims from U.S. insurers representing 21,000 physicians practicing in 46 acute care hospitals, for which injury was alleged to have occurred from 1979 to 2001.

Sixty-five percent of the claims involved missed diagnoses that resulted in adverse outcomes (including death in 39%). Emergency physicians were involved in 52% of the missed diagnosis claims, internists in 28%, and surgeons in 20%; trainees were involved in 56%. Process b…