Ali S. Saber Tehrani

25-Year summary of US malpractice claims for diagnostic errors 1986–2010: an analysis from the National Practitioner Data Bank

Background We sought to characterise the frequency, health outcomes and economic consequences of diagnostic errors in the USA through analysis of closed, paid malpractice claims. Methods We analysed diagnosis-related claims from the National Practitioner Data Bank (1986–2010). We describe error type, outcome severity and payments (in 2011 US dollars), comparing diagnostic errors to other malpractice allegation groups and inpatient to outpatient within diagnostic errors. Results We analysed 350 706 paid claims. Diagnostic errors (n=100 249) were the leading type (28.6%) and accounted for the highest proportion of total payments (35.2%). The most frequent outcomes were death, significant permanent injury, major permanent injury and minor permanent injury. Diagnostic errors more often resulted in death than other allegation groups (40.9% vs 23.9%, p<0.001) and were the leading cause of claims-associated death and disability. More diagnostic error claims were outpatient than inpatient (68.8% vs 31.2%, p<0.001), but inpatient diagnostic errors were more likely to be lethal (48.4% vs 36.9%, p<0.001). The inflation-adjusted, 25-year sum of diagnosis-related payments was US

Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: Toward an ECG for the eyes

38.8 billion (mean per-claim payout US

Rising annual costs of dizziness presentations to U.S. emergency departments.

386 849; median US

Small strokes causing severe vertigo Frequency of false-negative MRIs and nonlacunar mechanisms

213 250; IQR US

VOR gain by head impulse video-oculography differentiates acute vestibular neuritis from stroke

74 545–484 500). Per-claim payments for permanent, serious morbidity that was ‘quadriplegic, brain damage, lifelong care’ (4.5%; mean US

Quantifying the vestibulo-ocular reflex with video-oculography: Nature and frequency of artifacts

808 591; median US

Early adaptation and compensation of clinical vestibular responses after unilateral vestibular deafferentation surgery.

564 300), ‘major’ (13.3%; mean US

Vestibular signs of thiamine deficiency during the early phase of suspected Wernicke encephalopathy

568 599; median US

Damping of monocular pendular nystagmus with vibration in a patient with multiple sclerosis

355 350), or ‘significant’ (16.9%; mean US

Visual, Ocular Motor, and Cochleo-Vestibular Loss in Patients With Heteroplasmic, Maternally-Inherited Diabetes Mellitus and Deafness (MIDD), 3243 Transfer RNA Mutation.

419 711; median US