Diagnostic errors lead claims against primary care physicians

Diagnostic errors were the leading type of claims against primary care physicians from 2013 through 2017, says medical liability insurer Coverys, in a report issued Tuesday.

Other leading causes of malpractice claims include diagnostic allegations, medical treatment, medication and transitions in care, according to the report Red Signal Report, Claims Data Signals and Solutions to Reduce Risks and Improve Patient Safety, Patient Care, which is based on Boston-based Coverys’ closed claims during the five-year period.

Analyzing diagnostic issues further, the report said the top allegation for primary care providers involves inadequate patient assessment, which includes the capture of a complete family history, followed by the ordering of lab and diagnostic tests.

The top clinical conditions associated with this issue are cancer cases, which account for 50% of diagnosis-related claims, said the report.

Treatment-related claims are frequently associated with cardiac treatments, pain management, wound care and blood administration, said the report. The top medical treatment allegation is treatment management, which account for more than 60% of the claims.

The report said about 45% of the medication-related claims, and more than 50% of indemnity dollars paid, are directly related to inattentive monitoring and management allegations.

These are followed by medication ordering, which account for 33% of the medication-related claims and 38% of the indemnity dollars.

The top risk management issue associated with care transitions involve a delay or failure to obtain a specialty consultation when clinically indicated, which account for 38% of claims.

Recommendations in the report include improving diagnostic accuracy and treatment by regularly performing complete age-appropriate history and physical exams on every patient that includes cancer screening; closing the “referral loop,” including by engaging patients in the referral process; prescribing and administrating medications safely; and ensuring safe care transitions take place.

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