Pathology Errors

Like all areas of medicine, pathology errors can occur.  When a sample is taken from the patient, it must be labeled from where it came from in the patient.  It must then be sent to the pathology lab, where it retains its labeling as it is properly stored.  At some point it is sliced and stained with the proper stain.  It is properly labeled on a pathology slide and placed on the slide.  The pathologist reads the slide and makes the proper determination as to what the slide contains.  The pathologist connects the name of the patient with the slide determination and writes a summary of his or her findings.  This is sent to the patient’s doctor who then interprets what the pathologist’s summary says.  This is relayed to the patient.

This process can have errors at every step.  The specimen can be mislabeled from the start and when the information is transferred to the slide, the slide can be mislabeled.  The pathologist can read the specimen wrong or will misread the name of the patient.  The summary can contain the wrong name of .the patient or the wrong diagnosis. The patient’s physician may not understand the pathologist’s interpretation and may tell the patient the wrong thing.

Errors that tell a patient has cancer or that a patient doesn’t have cancer when the opposite is true are serious errors in medicine.  This type of error is dependent on the institution and happens 1.79-9.42 percent of the time.  The cause and percentage varied primarily because of errors from pathological interpretation. The cause of errors resulting from pathological errors was from 5-50 percent of the time.  The other errors were due to clinical sampling of the patient. About 39 to 45 percent caused patient harm with the higher percentage of harm related to gynecological errors.

In another study, it was found that the frequency of anatomic pathologic errors ranged from 1 percent to 43 percent of all specimens. The error rate for oncology was 1 percent to 5 percent.  There is, however, no uniform measurement process so that physicians have had trouble defining when an error has occurred.

The most common way to detect an error is to ask another pathologist to look at a particular slide.  It reduces the chance for error but doesn’t eliminate error because as the specimen is sectioned by the technician, the wrong part of the specimen might be given to the pathologists.  If the two pathologists disagree on the diagnosis in the specimen, then an error has been made by one of them and a third pathologist might have to become involved.

Unfortunately, one of the big problems is that detecting errors is not standardized; not everyone does it exactly the same way.  There’s no way to know if the pathologist doing the review is correct.  The only way to be sure about the diagnosis is to finally determine that what the patient has is correct. This can be dangerous if the diagnosis turns out to be cancer.

Pathology diagnosis is higher risk compared to some other medical fields because it involves the clinical competency of all members of the chain from the clinician to the pathologist and back to the clinician again who must make a determination as to the next steps of therapy based on his or her determination of the pathologist’s interpretation of the lesion or body area.

CLIA, the organization that oversees laboratories, doesn’t mandate how this process is supposed to be performed so laboratories are left to decide what policies to employ. Small laboratories with only one pathologist have a particularly difficult time figuring out what kind of policy can make sure that pathology slides are accurate and true. For More Detail Visit: Midwife Medical Negligence Compensation