Missed Diagnosis in the ICU Can Be Fatal

October 20, 2012 (Press-News.org) Missed Diagnosis in the ICU Can Be Fatal

What overlooked, potentially preventable factor leads to more deaths than breast cancer? The answer: misdiagnosis in hospital intensive care. A study of thousands of autopsy results, conducted by Johns Hopkins University School of Medicine and featured by HealthLeaders Media, has suggested that medical staff in intensive care units make fatal errors by misdiagnosing and failing to provide proper treatment in eight percent of their cases. Researchers estimate that as many as 40,500 adult patients in ICUs across the country, including Maryland, die every year because of a mistaken diagnosis.

Study's Findings on Misdiagnosis in Intensive Care Units and Suggestions

The most commonly missed ailments in ICUs are heart attack, aspergillosis, pulmonary embolism and pneumonia. Among them, those four medical conditions amount to a third of missed diagnoses. One missed diagnosis, Aspergillosis, is a fungal infection that can cause respiratory distress. Doctors often treat patients who come in with this symptom for a simple respiratory infection, using a treatment that is ineffective against aspergillosis.

The study's authors suggest several reasons why ICUs are inaccurate. First, there is a shortage of specialists in intensive care units who are able to monitor decision making. It is necessary that medical staff not only conduct proper analytic tests but also properly interpret the results of the tests, and a specialist would help provide oversight of that process. However, only 7,000 such specialists are certified in the United States.

Tests can yield conflicting results, and backup imaging and blood tests that resolve the conflict in information are not widely available for use in intensive care units. New equipment might be helpful, but the added care of an intensive care specialist according to the study's authors could save lives.

Another source of diagnostic error is insufficient nurse staffing. The ideal nurse staffing situation in an ICU is a one to one nurse-patient ratio, but understaffing could mean a far from ideal ratio of one to two.

Even if the nurse-patient ratio is favorable, nurses can suffer from alarm fatigue, where nurses lose focus due to a busy, noisy work environment. In intensive care units, monitors frequently beep and alarms are often triggered. False patient alarms occur often enough to desensitize staff to the point where they may not even notice them. Therefore, nurses may fail to respond at a critical moment, and as a result hundreds of deaths have been associated with alarm fatigue.

Finally, the researchers who conducted the study advocate the use of goal sheets and checklists of important questions that concern every ICU patient. A checklist of questions and tasks is especially helpful when a patient is unconscious and unable to communicate symptoms. For example, medical staff must keep track concerns like whether a patient is on a ventilator, whether a patient is ready to be taken off it and whether a patient should receive medication to prevent dangerous blood clots.

If you or a loved one has been injured because of a medical misdiagnosis, contact an experienced personal injury attorney who can enforce your legal rights.

Article provided by The Law Offices of Burch & Voss
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