Misdiagnosis Can Delay Adequate Treatment.
Misdiagnosis delays treatment and can result in long-term disability or death. Despite the serious potential consequences of misdiagnosis, there have been reports of an alarming number of diagnostic errors among patients with common problems. One of these commonly misdiagnosed disorders is pneumonia.
Pneumonia Can Often Be Seen on a Chest X-ray.
A chest x-ray in a person with pneumonia does not always have the characteristic “infiltrate” early in the course of the illness. Sometimes, the infiltrate may be in a portion of the lung that is not easily seen by standard x-ray, and other patients may have congestive heart failure or scarring in their lungs, which can mimic pneumonia. It’s important to distinguish pneumonia from these other problems because the treatment is very different. In fact, if someone is misdiagnosed with pneumonia and they have a different lung disease, they will probably continue to deteriorate clinically.
Signs and Symptoms of Pneumonia Help Make the Diagnosis.
When a doctor diagnoses pneumonia, there are five findings on examination that increase the probability of the diagnosis. These include:
- Fever: a temperature greater than 100.4 degrees Fahrenheit.
- Heart rate (pulse) more than 100 beats per minute
- Crackles or a Velcro sound (“rales”) heard in the lungs with a stethoscope.
- Decreased breath sounds.
- No asthma.
If a patient has five of these findings, they have a high probability of pneumonia, between 84% and 91%. If they only have one of these findings, however, the chance that their illness is due to pneumonia is only 5 to 9%, so the doctor should search for other causes of their cough, chest pain, or shortness of breath.
Doctors Sometimes Fail to Use Correct Diagnostic Criteria.
An article in ScienceDaily several years ago noted that doctors often fail to use diagnostic standards and criteria to diagnose pneumonia when readmitting patients after a period in the hospital for the same illness. This leads to unnecessary antibiotic use, an increased risk of acquiring another infection in the hospital, and additional expense, including time, missed at work.
Pneumonia is Commonly Misdiagnosed.
Pneumonia is the second most misdiagnosed condition leading to readmission after a previous hospitalization, second only to congestive heart failure. Blood tests and sputum cultures can be helpful to make the diagnosis of pneumonia. The diagnosis should be confirmed by X-ray, and if pneumonia is not evident, antibiotics should be discontinued and other causes of the patient’s symptoms should be sought. In healthcare clinics outside of the hospital setting, the diagnosis is often made solely on clinical symptoms and a physical examination.
If It’s Not Pneumonia, What Is It?
If a patient is misdiagnosed with pneumonia, the doctor may be missing the diagnosis and treatment of another significant lung disease. Chronic obstructive pulmonary disease (COPD) associated with smoking may result in lung sounds that are similar to pneumonia. Someone with asthma may simply be having an exacerbation that requires treatment with a bronchodilator like albuterol. People with heart failure also have crackles and rales, but a chest x-ray will probably show an enlarged heart. They don’t need antibiotics, but the use of a diuretic can be critical to keep that patient out of the hospital.
Less common diseases that may be confused with pneumonia include pulmonary emboli, or blood clots in the lung; bronchiectasis, and lung cancer.
Diagnostic Errors Occur Frequently in Medicine.
Diagnostic skills are fundamental to the practice of medicine, yet misdiagnosis causes death or disability to over 150,000 patients annually. The Journal of the American Medical Association published an article by well-known safety expert, Dr. Peter Pronovost, who noted that our patient safety programs generally fail to diagnose diagnostic errors. The authors reported 40,000 to 80,000 deaths occur in the United States each year as a result of misdiagnosis, and they later stated that 100,000 annual deaths due to misdiagnosis was probably more accurate. Until the medical profession addresses this problem systematically to improve skill and accuracy, patients should be alert for problems that fail to respond to treatment or symptoms that become worse rather than improved.
Have You Been Misdiagnosed with Pneumonia?
If you have been misdiagnosed with pneumonia, later to find you were experiencing an exacerbation of heart failure, a blood clot, or even lung cancer, you may have recourse for injuries as a result. You may have been unnecessarily admitted to the hospital, putting you at risk of an iatrogenic injury or infection. Damages may include hospital bills, morbidity, and even mortality. If you or a love one has experienced a misdiagnosis of a lung problem as pneumonia and your actual problem was not treated appropriately, call our office for a consultation with an experienced Chicago malpractice attorney. If you were injured by misdiagnosis, you may have been the victim of medical negligence or malpractice.
