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Many Misdiagnoses Are the Result of Cognitive Errors

Some misdiagnoses that occur in emergency rooms in North Carolina may not be because of hospital processes but as a result of physicians' cognitive errors. Researchers conducted a study at an urban public hospital and found that 45 percent of the errors were the result of processing information wrong.

The study examined data over an eight-month period for patients who made a second visit to the emergency room in 72 hours and were admitted on that second visit. It identified 52 errors. Faulty verification was responsible for nearly one-third of all errors while 18 percent were because of faulty information gathering and 6 percent were because of knowledge errors.

The principal investigator said he and his fellow researchers assumed that most errors would arise from faulty patient information or a lack of medical knowledge. Their findings instead were that as was the case in non-emergency situations, doctors had the right information but still sometimes came to the wrong conclusions. He made several suggestions for physicians to reduce the likelihood of this happening including coming to work well-fed and well-rested. He also said that doctors should consider spending a little more time with patients who returned for another visit and might want to ask a colleague for a second opinion. In turn, he said patients whose conditions persisted should go back to the emergency room for another opinion.

failure to diagnose a dangerous condition, such as a stroke or a heart attack, can cause a serious health setback or can even be fatal. When determining whether medical malpractice has occurred, the legal system accounts for the fact that some conditions take longer to diagnose because of testing or the necessity of ruling out certain possibilities. An experienced attorney will obtain the opinions of one or more medical experts in order to determine whether the requisite standard of care was breached.


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