Characteristics and Trends of Medical Diagnostic Errors in the United States

Hei Sio Ao (sa204785@atsu.edu) has been awarded a doctor of health sciences degree and a certificate for academic excellence from A.T. Still University. She is an American Society for Clinical Pathology–certified technologist in molecular biology. She has worked in the laboratory science and health science fields.

*Corresponding author

​Tracy Matthews is a committed faculty member at A.T. Still University, where she plays an integral role in advancing healthcare education and research. In addition to her academic background, she is currently pursuing a law degree, set to be completed in 2025, which will expand her expertise into healthcare law and enhance her professional impact.

Diagnostic errors could lead to severe harm resulting in permanent disability or death. Previous studies suggest that diagnostic errors are prevalent in the United States. A better understanding of the characteristics and trends of diagnostic errors would help identify priority areas for improving patient safety. This quantitative descriptive research study aims to explore the characteristics and trends of diagnostic errors in the United States.

This study analyzed 226,781 paid malpractice claims data (1999–2018) included in the National Practitioner Data Bank Public Use Data File using IBM SPSS Statistics. Descriptive statistics were used to summarize and describe the data of variables of interest. Normality test, chi-square tests, and Mann-Whitney U tests were also performed for data analysis.

This study found that diagnosis-related allegations accounted for a high proportion of malpractice allegations and payment during the 20-year period, and many of them were linked to cases associated with disability or death. The leading specific malpractice allegations were failure to diagnose, delay in diagnosis, wrong or misdiagnosis, and failure to order appropriate test. The results showed that some sample characteristics, including patient gender, patient type, patient age group, and practitioner age group, were statistically significantly associated with diagnosis-related allegations linked to disability/death outcome or higher malpractice payment. While the overall trends for diagnosis-related allegations were downwards, the overall trends were upwards for diagnosis-related allegations associated with inpatients.

This study suggests that reducing diagnostic errors remains a priority area for improving patient safety.