Diagnostic Mistakes: The Most Frequent Pediatric Medical Errors

A recent study published by the Doctors Company shines light on preventable pediatric medical errors, the primary cause of errors, and how the type of errors change as children age.  While no parent wants to imagine that their child could be the victim of a medical error, the fact is that medical mistakes can happen to anyone, and there is no real way to prepare.

The best that we can do, instead, is do our part to understand the causes of pediatric medical errors, and create and enforce guidelines to reduce the risk.  Research has suggested that approximately 2-3 percent of hospitalized children will experience medical malpractice.  The cause for the vast majority of these injuries is diagnostic mistakes.

Understanding Pediatric Medical Errors

In April 2019, The Doctors Company published the results of a study that analyzed over 1,200 legal claims involving pediatric medical errors.  Researchers broke down the victims into four categories:

  • Newborns
  • Children in the first year of life (age 2 months to 11 months)
  • Children aged 1 to 9
  • Teenagers 10-17

For each group except newborns, claims involving diagnostic errors were the most common.  Claims involving newborn injuries were mostly related to obstetric care (birth injuries), but diagnostic failure did account for the second most frequent cause of claims for injured newborns.

The study found that obstetricians are most commonly named in lawsuits related to pediatric medical errors.  Among the cases studied, only 37 percent of claims ended in payment to the victim’s families. The average monetary award in the winning cases was more than $630,000.

pediatric medical errors

Most Common Injuries from Pediatric Medical Errors

The type of medical errors that The Doctors Company found varied among age groups.  However, among all four age groups, brain injuries were the most frequently reported pediatric medical error.  Among each age group, brain injuries accounted for:

  • Newborns – 48%
  • 0-1 Years – 36%
  • 1-9 Years – 15%
  • Teenagers – 11%

Aside from brain injuries, the medical errors reported varied.

Newborn Injuries:

  • Arms – 19%
  • Genitals – 5%
  • Blood – 4%
  • Legs – 4%

0-1 Year Old Injuries:

  • Lungs and respiratory system 20%
  • Heart – 15%
  • Blood – 9%
  • Hips – 4%

Children in this category experienced the highest death rate among all age groups studied – a heartbreaking 30 percent.

1-9 Year Old Injuries:

  • Lungs and respiratory system – 9%
  • Eyes – 6%
  • Heart – 4%
  • Teeth – 4%

10-17 Year Old Injuries:

  • Teeth – 6%
  • Knees – 4%
  • Abdominal cavity – 4%
  • Lower legs – 4%

Pediatric Diagnostic Medical Errors

When preventable pediatric medical errors were observed in the study, the cause was most often a problem with diagnosis.  Diagnosis is so crucially important to medical care.  Failure to arrive at the correct diagnosis can delay life-saving treatment.  Diagnosis of the wrong condition can harm a patient who may then receive unnecessary or inappropriate treatment.

The Doctors Company said, “Diagnosing children can be more challenging than diagnosing adults.” Between 36-42 percent of the children in this study were injured because their doctors failed to assess their symptoms correctly.  Some of the reasons that a diagnostic error might occur include:

  • Pediatric symptoms may seem generalized and may not necessarily indicate a specific condition.
  • Preverbal children may not be able to describe symptoms. Young kids may not be able to explain what they are feeling.
  • Parents may not realize the clinical significance of symptoms and won’t disclose them.
  • Doctors and nurses fail to ask questions that could uncover important information.
  • Doctors and nurses fail to take a complete patient history including family history that could lead to a timely and correct diagnosis.
  • Clinicians depend on memory to make decisions instead of referring to reliable records.
  • Record-keeping methods fail. Electronic records can get lost or deleted, and human error can result in incorrect information.
  • Delay or failure to order diagnostic tests.

Like everyone else, doctors and nurses can be influenced by their feelings.  They can also become distracted and just make mistakes.  The crucial difference between pediatric medical errors and any other kind is that patient lives and health hang in the balance when doctors have a bad day at the office.

Expert Witnesses Identify Pediatric Medical Errors

In the legal claims that arose from these pediatric medical errors, expert physician witnesses identified inadequate assessments that resulted in incorrect diagnoses.  These children suffered because the medical professionals tasked with their care did not collect important information or failed to incorporate key information into their diagnosis.

The expert witnesses who consulted on the study revealed doctors misdiagnosed these children because they failed to recognize the relevant clinical factors when the information was available.  These clinicians failed to correctly diagnose children even when they had accurate:

  • Patient histories
  • Reported Symptoms
  • Physical exams
  • Test results

The accused medical providers’ medical training should have prevented such an error, and that is why their behavior prompted malpractice claims.

The Special Circumstances of Newborn Medical Care

Children in the first year of life are very fragile and have more specialized healthcare needs. Naturally, the medical community considers care of newborn babies to be high-risk for the pediatric medial errors that result in injury.  Injuries among very young infants in this study included:

Brain injuries were the most frequent injury among newborns, and most other injuries claimed to be pediatric medical errors centered on injuries from a traumatic or mismanaged birth.

Advice for Parents of Pediatric Patients

A physician’s inadequate assessment of pediatric patients and subsequent misdiagnosis frequently boils down to a failure in communication.  As parents, there is nothing you can do to help your child’s doctor arrive at a correct diagnosis except try to keep up reliable communication.  Communication failures between families and medical providers factored in 15-22 percent of the claims in this study.

So, what can parents do to ensure that they are communicating properly?  Consider the following:

  • Do your best to remain calm and polite.  Doctors have emotions just like everyone else and are more prone to mistakes after an unpleasant interaction with patients.
  • Pay very close attention when your doctor describes conditions and symptoms that need emergency medical care.
  • In the heat of an emergency, take the time to fully and accurately answer every question the providers ask.  Your child’s care may be compromised if the facility does not have a thorough patient history.

Need to Know More? Birth Injury Guide is Here for You.

This recent study examined the causes of more than 400 preventable pediatric medical errors – more than 400 families whose children’s lives were forever changed by a preventable mistake.  No one wants to imagine tragedy will come near their family, but pediatric malpractice happens.

If pediatric medical errors have impacted your family, call 1-877-415-6603 to talk to the compassionate lawyers at Birth Injury Guide.  You can also contact us online to schedule a free consultation.

 

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