Articles Posted in Misdiagnosis

Doctors working in hospital emergency departments face chaos, violence and high stress every day, and usually they get the diagnosis and treatment right. But, and it’s a big but, as often as one in seventeen ER visits ends with a misdiagnosis, which can have deadly consequences. Those medical misdiagnosis are newly estimated by Johns Hopkins medical school researchers as a significant peril for patients across the country.

Doctors in the too-often harried ER environs fail to correctly “identify serious medical conditions like stroke, sepsis and pneumonia,” leading to the deaths of as many as 250,000 patients each year, researchers at the Johns Hopkins University Evidence-based Practice Center found in their work for a federal health care oversight agency. The New York Times reported this of the work:

“The study, released [Dec. 15] by the Agency for Healthcare Research and Quality, estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result. Researchers from Johns Hopkins University, under a contract with the agency, analyzed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake. Many of the studies were based on incidents in European countries and Canada, leading some officials of U.S. medical organizations to criticize the researchers’ conclusions.

heart3-150x150As cardiologists and other medical specialists grow increasingly aware of big differences in the heart and circulatory health of men and women, researchers also are prodding doctors who take medical histories of female patients to be sure to ask simple but important questions about their experiences with problem pregnancies.

That’s because vital preventive information can be surfaced, if clinicians learn, for example, that their patients had preeclampsia, “a complication that occurs in about 5% of pregnancies and in which dangerously high blood pressure can lead to seizures, organ failure, and death,” according to Stat, a science and medical news site. As Stat reported:

“Women who have preeclampsia have more than twice the chance of developing cardiovascular disease later in life compared to women who had pregnancies without it …Today, a growing subset of care providers is advocating for closer follow-up of the millions of people who have had preeclampsia and other complications during pregnancy that signal an increased risk for cardiovascular disease. Given that about one in three women in the U.S. have cardiovascular disease, better screening of people with pregnancy complications could help protect them before they develop the disease in the first place.

pulseoximeter-150x150Until the coronavirus pandemic struck, few regular folks knew about pulse oximeters, much less had one on hand for urgent use. The devices, which fit over a finger, are supposed to give fast readings on the levels of oxygen in patients’ blood — a key measure of their respiratory wellness.

But the devices, whether in relatively inexpensive consumer versions or in medical-grade units used in doctor’s offices, clinics, and hospitals, are far from perfect. They suffer major inaccuracies when used by those with darker skin.

Federal regulators have known about this flaw for years. But at a time when patients, families, doctors, and hospitals relied on the devices routinely to make critical treatment decisions affecting those struggling with likely coronavirus infections, an information chasm opened. Doctors urged people to pop by drug stores and other retailers to pick up the devices, saying that they could be helpful in letting them know when their oxygen levels were dipping in concerning enough fashion that they should seek emergency treatment.

healthrecords-150x150Patients have hit a red-letter day in the long, too-difficult struggle to win control of a crucial part of their care — their electronic medical care records. Hospitals and other caregiving institutions no longer can block access to these documents, with federal law now holding them accountable for any runarounds they may try.

As Stat, a medical and science news site,  reported:

“Under federal rules taking effect [Oct. 6,2022], health care organizations must give patients unfettered access to their full health records in digital format. No more long delays. No more fax machines. No more exorbitant charges for printed pages. Just the data, please — now. ‘My great hope is that this will turn the tide on the culture of information blocking,’ said Lisa Bari, CEO of Civitas Networks for Health, a nonprofit that supports medical data sharing. ‘It’s a ground level thing to me: We need to make sure information flows the way patients want it to.’”

nwsl-logo-150x150tua-150x150While fans may wax poetic about how sports show humanity at its finest, the grim and even sleazy aspects of U.S. games also have been on full display in recent days.

The poohbahs of two of the nation’s most popular pastimes have acted poorly and spoken loudly as to how, maybe they don’t really give a whit about players’ health and well-being, permitting perversity and demeaning behaviors to flourish in women’s soccer and brutality and an almost willful medical blindness to rise anew in pro football for head trauma.

What are parents supposed to tell their kids about such sports “role models?”

howardhospitallogoHospitals have raised major alarms with insurers, businesses, and patients by asserting that spiking costs for medical staff, especially nurses, will lead them to increase their prices in the days ahead by as much as 15%.

This would be a budget-busting move, breaking contracts the caregiving institutions have struck with employers and insurers, leading not only to potential premium shocks but sharply higher charges for patients, the Wall Street Journal reported.

The newspaper noted that the soaring hospital price plans are coming up in negotiations now among chains like HCA Healthcare and Universal Health Services, companies, and insurers, differing markedly from typical discussions on this always tough issue:

chromosomes-harvardExpectant parents, doctors, and regulators need to reconsider the rising use of gee-whiz genetic testing as  doubts emerge about popular blood screenings to detect rare prenatal disorders and a costly test relied on by couples undergoing in-vitro fertilization (IVF) treatment.

This is what the New York Times reported about what researchers have found about preimplantation genetic testing for aneuploidy, or PGT-A. It is an increasingly common screening in IVF and has led potential parents to discard embryos as unfeasible or unacceptable due to abnormalities to carry to term:

“PGT-A … has, over the last two decades, become a standard add-on to already pricey IVF procedures. But the test, which can cost anywhere from $4,000 to $10,000, has become controversial over the years as studies have cast doubt on whether it increases birthrates from IVF at all. A growing number of scientists have questioned the widespread use of the test, which leads to tens of thousands of discarded embryos per year and causes many women to believe they may not be able to carry biological children. A new study published last week details 50 patients who underwent transfers of abnormal embryos at the Center for Human Reproduction in New York City … The study reported eight births after 57 transfer cycles of embryos with abnormal genetic testing results since 2015. Seven of the babies were born healthy. The average age of the women in the study was 41 years old.

abuse-150x150Women suffer significant, sustained damage from head traumas inflicted on them during domestic abuse, and victims themselves, doctors, law enforcement, and too many others have underestimated the severity of this problem.

Here is the harsh reality of too many women’s terrifying experiences, as reported in a tough-to-read but important New York Times magazine article that quotes, among others, Eve M. Valera, an associate professor of psychiatry at Harvard University and a leading researcher on traumatic brain injuries among survivors of domestic violence:

“The Centers for Disease Control and Prevention estimates that one in five women in the United States experience severe intimate-partner violence over the course of their lifetimes, resulting in physical injuries, most commonly to the head, neck and face. Concussions are likely to appear with alarming regularity. Every year, hundreds of concussions occur in the [National Football League]; thousands occur in the military. Valera’s estimated number of annual brain injuries among survivors of domestic abuse: 1.6 million.

medicalrecords-150x150Patients, for their own protection, long have needed to secure copies of their medical records and correct inaccuracies they find  — a safeguard that has grown even more vital as research builds about unacceptable biases that doctors and others may show in their recorded observations about those in their care.

In two separate, published dives into tens of thousands of medical records, researchers found that black patients were 2½ times more likely than their white counterparts to be labeled with at least one negative description, and African-Americans with diabetes were more likely than whites to be labeled with medically disapproving terms including nonadherence, noncompliance, failed or failure, refuses or refused, and, even combative or argumentative, the New York Times reported.

Dr. Dean Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center and who was not involved in the studies, told the newspaper this of the disconcerting descriptions found in patient records:

weedn-150x150It’s a grim issue that too many of us would want to ignore in the best of times. But the coronavirus pandemic and its collateral harms have pushed beyond their  limits the medical experts who study death, locally and nationally.

In Maryland, the chief medical examiner has resigned, and a deputy has been designated as the interim head of one of the nation’s busiest morgues, the Washington Post reported. Victor Weedn (shown right), who had served as the operation’s head since 2019, stepped down as the facility has gotten stuck in such snafus that it has more than 200 bodies awaiting autopsy, “the biggest backlog the office has seen.” The nightmarish mess matters, the Washington Post reported:

 “The logjam has left families distraught as they experience extended delays in funerals. It has also created problems with some [criminal] prosecutions, with holdups in courts obtaining autopsy reports and getting stand-in medical examiners for murder trials. In the past couple of months, the caseload in Maryland has increased by nearly 400%. There were 50 bodies awaiting autopsies in late December. The number swelled to 240 last week. Weedn recently estimated that the office would have a backlog of 300 this month. He and other medical examiners across the country have blamed backlogs on a combination of staffing shortages and rising deaths because of violence, Covid-19, and drug overdoses.”

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