Misdiagnosis and Prescription Errors Responsible in Most Claims for Negligence against GPs

Misdiagnosis and prescription errors have been identified as being the most common reasons for claims for negligence against GPs according to a report commissioned by the Royal College of Surgeons Ireland.

The report – “The Epidemiology of Malpractice Claims in Primary Care: A Systematic Review” – was prepared by the Centre for Primary Care Research in Dublin with the aim of identifying which areas of primary care needed specific attention when planning future educational strategies and developing risk management systems for primary healthcare practitioners.

The key findings of the report were published in the British Medical Journal and included:-

  • The misdiagnosis or delayed diagnosis of cancer was the most common individual reasons for making claims for negligence against GPs.
  • The most frequently misdiagnosed cancers were breast cancer, colon cancer, lung cancer and cancer of the female genital tract.
  • The second most common grounds for successful negligence claims against GPs were prescription and medication errors.
  • The misdiagnosis of heart attacks also accounted for a significant number of claims for negligence against GPs and primary healthcare practitioners.
  • The most frequently misdiagnosed condition for children was appendicitis, but the incorrect diagnosis of meningitis accounted for 30% of compensation paid.
  • The annual prevalence of claims for negligence against GPs for missed diagnosis or delayed diagnosis appears to be on the increase

Lead researcher for the report – Dr Emma Wallace – admitted that primary healthcare practitioners are referring patients to consultants more frequently, as the fear of litigation inhibits their willingness to make diagnoses. This situation is leading to patients´ conditions deteriorating unnecessarily and creating more pressure on an under-resourced health service.

Dr Wallace – who is herself a GP – acknowledged that claims for negligence against GPs were “not a perfect substitute for adverse events”, but said that when medical negligence claims are made against GPs, the medical practitioners involved often experience increased levels of stress – reducing the effectiveness of service they are able to offer, and placing more patients at risk of a delayed diagnosis or medication error.

She added “this systematic review is timely considering the increased interest in focusing on primary care as a way of improving patient care and safety” and she hoped that the report would provide an insight into the types of adverse effects in clinical practice and their causes, which would subsequently increase the standard of primary care and reduce the number claims for negligence against GPs in Ireland.