BURYING MISTAKES
Hospital autopsy rates have fallen in the last 35 years from over 40% to 5%[1].
A major factor has been fear of medical malpractice litigation, particularly since 1970 when hospital accreditation ceased to require minimum autopsy rates.
In 1974, a Swedish study[2], [3] of autopsies found an error rate of 25% in fairly certain clinical diagnoses, 45% in diagnoses which were judged probable.
PRACTICE POINT Autopsy studies suggest that up to 10% of principal diagnoses are seriously erroneous |
Nearly 10 years later, a study[4] of 300 cases from 3 decades found errors in over 20%, nearly half of which, if known, might have resulted in change of therapy and prolonged survival.
Analysis of more than 50,000 autopsies nine years ago led the authors[5] to resurrect and promote a theory of Necessary Fallibility which "results from extremes of variations in the presentations of diseases, in guises that may mislead physicians to the wrong diagnosis."
PRACTICE POINT Because the range of clinical features of any disease is so wide, one disease sometimes masquerades as another and major diagnostic errors may be inevitable |
For all its other shortcomings, no-fault compensation would provide an environment more conducive to necessary medical learning from mistakes.
Copyright © 2008 Electronic Handbook of Legal Medicine