Missed Diagnosis of Cardiovascular Disease in Outpatient General Medicine: Insights from Malpractice Claims Data

Researchers looked at 251 closed medical malpractice cases in the CRICO Strategies National Comparative Benchmarking System (CBS) where patients alleged that the general medical practitioner who treated them in an outpatient setting missed a cardiovascular diagnosis. These cases were more likely to result in higher severity injury than malpractice claims in general, the study showed. Key findings included:

• Almost a quarter of the patients in the analysis who were eventually diagnosed with myocardial infarction or coronary atherosclerosis had a history of prior cardiovascular disease—one of the highest pretest predictors of cardiovascular disease.

• The majority of patients with missed outpatient coronary artery disease had initial diagnoses that were either nonspecific or common disease mimics (for example, esophageal reflux or musculoskeletal pain), despite the high prevalence of cardiovascular risk factors among those patients.

The article is available as open access through the Joint Commission Journal on Quality and Patient Safety.

Citation for the Full-text Article

Quinn G, Ranum D, Song E, Linets M, Keohane C, Riah H, Greenberg P. Missed diagnosis of cardiovascular disease in outpatient general medicine: Insights from malpractice claims data. The Joint Commission Journal on Quality and Patient Safety. October 2017; 45(10):508-516. https://doi.org/10.1016/j.jcjq.2017.05.001