Missed and Delayed Diagnoses in the Ambulatory Setting
Authors: Tejal K. Gandhi, Allen Kachalia, David M. Studdert
Journal: Annals of Internal Medicine (2007)

Letters20 March 2007Missed and Delayed Diagnoses in the Ambulatory SettingTejal K. Gandhi, MD, MPH, Allen Kachalia, MD, JD, and David M. Studdert, LLB, ScDTejal K. Gandhi, MD, MPHFrom Harvard School of Public Health, Boston, MA 02115.Search for more papers by this author, Allen Kachalia, MD, JDFrom Harvard School of Public Health, Boston, MA 02115.Search for more papers by this author, and David M. Studdert, LLB, ScDFrom Harvard School of Public Health, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-6-200703200-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We agree with Dr. Clairmont's suggestion that greater transparency of errors in malpractice claims would advance patient safety. If appropriately identified, such information could help pull the liability system toward a broader culture of openness in which mistakes are seen as valuable opportunities to improve care, not as problems to be hidden. All errors, regardless of whether they prompted malpractice claims, should be construed and discussed in this light.We are disappointed by Dr. Clairmont's view that our findings will not help primary care physicians. By highlighting several points in the diagnostic processes in which breakdowns frequently occur ...References1. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991;324:370-6. CrossrefMedlineGoogle Scholar2. Thomas EJ, Studdert DM, Burstin HR, Orav EJ, Zeena T, Williams EJ, et al. Incidence and types of adverse events and negligent care in Utah and Colorado. Med Care. 2000;38:261-71. CrossrefMedlineGoogle Scholar3. Thomas EJ, Petersen LA. Measuring errors and adverse events in health care. J Gen Intern Med. 2003;18:61-7. CrossrefMedlineGoogle Scholar4. World Health Organization. More than words: international patient safety event classification. Accessed at www.who.int/patientsafety/taxonomy/en/ on 4 December 2006. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard School of Public Health, Boston, MA 02115.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMissed and Delayed Diagnoses in the Ambulatory Setting: A Study of Closed Malpractice Claims Tejal K. Gandhi , Allen Kachalia , Eric J. Thomas , Ann Louise Puopolo , Catherine Yoon , Troyen A. Brennan , and David M. Studdert Missed and Delayed Diagnoses in the Ambulatory Setting Thomas P. Clairmont Jr. Missed and Delayed Diagnoses in the Ambulatory Setting Joseph E. Marine Missed and Delayed Diagnoses in the Ambulatory Setting Eta S. Berner , Randolph A. Miller , and Mark L. Graber Metrics 20 March 2007Volume 146, Issue 6Page: 470-471KeywordsAdverse eventsArmed forcesConflicts of interestFatigueGlobal healthInformation storage and retrievalInformation technologySafety ePublished: 20 March 2007 Issue Published: 20 March 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...