Diagnostic errors are an understandable patient concern in any clinical setting. But just how often do they actually occur, particularly in emergency rooms?

That is what the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) set out to determine, conducting a systematic review of nearly 300 studies published between January 2000 and September 2021.

On December 15, 2022, AHRQ published a report of its findings—some of which are exceptionally alarming.

Diagnostic errors in the ER: a look at the numbers

From the 19,127 citations and 279 studies assessed, AHRQ researchers estimate that 7.4 million emergency room misdiagnoses occur each year.

This includes:

• 2.6 million people experiencing harm that could have been prevented

• 370,000 people who die or become permanently disabled due to ER misdiagnoses

• 1,400 diagnostic errors per emergency room each year across the United States

Of these misdiagnoses, the top 15 conditions were:

1. Stroke

2. Myocardial infarction

3. Aortic aneurysm and dissection

4. Spinal cord compression and injury

5. Venous thromboembolism

6. Meningitis and encephalitis (tied with #7)

7. Sepsis (tied with #6)

8. Lung cancer

9. Traumatic brain injury and traumatic intracranial hemorrhage

10. Arterial thromboembolism

11. Spinal and intracranial abscess

12. Cardiac arrhythmia

13. Pneumonia

14. Gastrointestinal perforation and rupture

15. Intestinal obstruction

Of these conditions, the top five accounted for 39% of serious harms related to misdiagnosis.

Countering the report’s findings

Despite these findings, some of the country’s leading physician groups—including the American College of Emergency Physicians and the American Board of Emergency Medicine—issued a letter countering the report, stating that it makes “misleading, incomplete, and erroneous conclusions” and “unnecessarily disparages the practice of emergency medicine in the United States.”

“We recognize and respect that [the researchers] followed their standard procedure, which included an opportunity for public comment,” states the letter. “However, we are also deeply concerned that publishing this faulty document would have negative implications for both our current workforce and our future pipeline of emergency physicians, as well as the millions of people who seek emergency care in the U.S.”

The letter recognizes that, as with all specialties, there is room for improvement in the diagnostic accuracy of emergency care. However, it also brings up concerns that some elements of the research may introduce errors—such as the applicability of the references cited and the usage of malpractice data.

What to do if you are misdiagnosed in the emergency room

Regardless of the report’s validity, the fact remains that misdiagnoses can and do occur throughout all clinical settings, particularly in emergency rooms. Not only are ER settings usually filled with patients who have experienced serious injuries or illnesses and are often in a significant amount of pain, but they also tend to be understaffed—a combination that can easily lead to mistakes.

If you or your loved one have experienced an emergency room visit that resulted in more harm than good, you may be the victim of medical negligence, or malpractice, and have viable claims to pursue.

Given the nature of ER settings, it is to be expected that some conditions or diagnoses may be overlooked. To prove medical malpractice, you will need evidence that another doctor would have made a comparable determination given the same circumstances, and proof that the misdiagnosis had a direct negative impact on you or your loved one’s health.

For best results, consult with a knowledgeable medical malpractice attorney who can fight for your best interests.