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Diagnostic Errors Found in 1 of 4 ICU Patient Deaths

Cheryl Clark, for HealthLeaders Media, August 28, 2012

"The papers seem to be complaining about that, rather than recognizing that we're missing all these diagnoses, and we need to fix the system so we don't miss them. Just increasing the number of autopsies isn't going to fix the problem because these patients are already dead."

The JHU researchers say that while performing autopsies helps identify the manner and cause of death, and point to common mistakes, the real need is to develop better ways ICU providers can "measure the prevalence and impact of diagnostic errors and potential strategies to reduce them."        

The paper was published online last month by the BMJ Quality & Safety.

Winters gave two examples of the most serious types of errors frequently identified:

"A patient comes in with certain symptoms and is treated for a pulmonary embolism (a clot in the lung), but an autopsy determines the patient didn't have a PE, but a heart attack," he says.

Another common error is the misdiagnosis of the fungal infection aspergillosis, which can affect patient with damaged immune systems. "The patient may come in with acute respiratory distress syndrome and is treated for a respiratory infection because no one recognizes that the patient has aspergillosis, which requires a very different treatment."

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