I have been a legal nurse consultant since 2006 and learned a lot regarding adverse events in healthcare. Unfortunately, medical harm is a growing issue that can result in injury and lawsuits. Whether intentional or unintentional, if harm occurs and is proven to be caused due to a significant deficit in a clinician's competency, damages can be awarded to compensate for the harm. Medical misdiagnosis is a form of medical harm that occurs annually at a rate of 1 in 20 people (Smith et al., 2021). Prevention is key to avoiding risk or worsening conditions or even death. Therefore, misdiagnosis or delayed diagnosis reduces the time for treatment, which can lead to poor outcomes in mortality or morbidity. It is important for providers and organizations to address chronic symptoms, and have appropriate pathways of assessment, diagnosis, intervention, and follow-up promptly to avoid negative experiences. The failure to provide reasonable care and accurate clinical processes can lead to a claim of negligence. Shockingly, 12 million people are reported to have a medical misdiagnosis annually, according to a news article by a dually prepared physician attorney (Wilson, 2024). Misdiagnosis is preventable and needs scrutiny to prevent fatalities.
The common themes for a misdiagnosis include the following:
Incomplete or incorrect patient information
Errors in interpreting test results
Failure to recognize a disease or condition
Overlooking or misinterpreting symptoms
Cognitive biases of healthcare providers
Through a personal lens, I would like to share a medical harm brief anecdote. I have experienced a delayed diagnosis in 2008 when my husband's colon cancer was not detected after two emergency room admissions. He was only 33 years old, and the presenting symptoms were dismissed as abdominal pain. The presumptive bias of each ER doctor that he was a young and healthy person because of his work and hobbies truly clouded the judgment to misinterpret the quiet and underlying risk. Two weeks after the first admission, he was confirmed with Stage IV colon cancer with liver mets and died 19 months later. Learning how delayed diagnosis, especially in young patients, is a common theme, particularly at risk in emergency services and oncologic care, is so disheartening. One initiative that would have helped reduce misdiagnosis risk would have been a pathway for comprehensive screening that included genetic components. They denied a colonoscopy or any stool screening at that time. The solution both times was hydration, rest the gut, taking some golytlely stimulant powder and trying to poop. It wasn't until two weeks later when he was sallow in color, stooling fecal matter from his nose, and the belly obtunded did we get urgent evaluation and more invasive support. We now know that early-onset GI cancers are on the rise, and with any familial risk, a deeper screening or exam discovery should have been advised. The standardized gastrointestinal assessment in the emergency room discounted the risk that should have been evaluated. We discovered after a comprehensive intake in follow-up of the vast genetic component to this situation. In the ER, it was simple denial to consider that his abdominal pain and weight changes without the presence of blood in stool were dismissed as simple constipation. A misdiagnosis occurs due to faulty systems, incorrect testing, or missed symptoms. Now, since his cancer was progressive, that initial visit may not have changed the outcome, but certainly, the lack of diagnosis in acuity caused harm to himself and others through psychological pain. Unfortunately, in our state psychological pain is not compensated. Unless there were other medical harm issues like medication errors, then a diagnostic error claim could have been reasonable for causation. This has been my personal experience that ignited my clinical passion for personalized care, advocacy in education, and legal nurse consultations to help patients and families cope with personal injury case work often due to medical harm or medical trauma.
2009 Crawling through the Inflatable Colon 2010 Last pics with Carson and her dad Freedom or Fear ? You must choose to deal with genetic risks and test don't guess! Faith is truly the only thing that helped get through every trauma with decisions that were made and the disruptive truths of family medical catastrophe.
Catastrophic illness support is needed for those who also have dealt with medical trauma. This began a health policy and advocacy career shift in my nursing aptitude and became a Colon Cancer Alliance Ambassador to Call on Congress! (more on that but the poster is in my office from Times Square and Capital Hill )
RIP: Shannon Hamilton 01/29/1975 -07/05/2010
--Nurse Nikol
Reference
Wilson, D. M. M. (2024, November 29). The Dangers of Medical Misdiagnosis. Retrieved January 29, 2025, from https://wilsonlaw.com/blog/the-dangers-of-medical-misdiagnosis/
Smith, K., Baker, K., Haskell, H., Hill, M., & Tate, J. (2021). Using Patient Experience Surveys to Assess Diagnostic Safety in Urgent Care. Health Services Research, 56(Suppl 2), 53–54. https://doi.org/10.1111/1475-6773.13822
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