CRICO | Strategies for Patient Safety


Malpractice Risks in the
Diagnostic Process

  by Jock Hoffman, Senior Editor for Patient Safety, CRICO    

Allegations of diagnostic errors lead to 20 percent of all medical malpractice claims and lawsuits. More than half of those (57%) stem from ambulatory care. The average payment for such cases (closed from 2008–2012) was $442,000.

Based on more than 2,600 cases from CRICO Strategies’ national Comparative Benchmarking System (CBS), the 2014 Annual Benchmarking Report: Malpractice Risks in the Diagnostic Process is a thorough exploration of diagnosis-related cases stemming from care in an ambulatory setting. This in-depth study provides unique insight into where, when, and how things can go wrong for patients and providers trying to make an accurate and timely diagnosis.

Illustration: infographic preview


To enhance the analysis, CRICO mapped the underlying issues (i.e., the contributing factors) against 12 steps that define the Diagnostic Process of Care. This serves as the framework for the 2014 Report, with detailed attention given to three broad areas of diagnostic risk:



of cases


the initial assessment



of cases


testing and results processing



of cases


follow up and coordination of care

Most notably, our analysis pinpoints where in the clinician’s thought process—or where in a practice’s communication and data management systems—mistakes are most likely to occur.

pie graph showing 3% slice  


of assessment cases


had an atypical presentation

In conjunction with the malpractice data analysis, CRICO spoke with several members of the Society to Improve Diagnosis in Medicine and have included their insights alongside the data displays and case examples.

“We assume we’re right when we make a diagnosis unless we hear otherwise, then we keep making the same mistakes over and over again”

—Robert Trowbridge, MD, Maine Medical Center

Through its Annual Benchmarking Report, CRICO Strategies strives to use the power of its robust CBS database to raise awareness and spur on efforts to improve patient safety. The goal for the 2014 report is to accelerate the development and adoption of a broad set of effective solutions to the cognitive and systemic problems that can impede prompt and accurate diagnoses.


December 2014



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CRICO, a recognized leader in evidence-based risk management, is a group of companies owned by and serving the Harvard medical community.

CRICO Strategies is a division of Risk Management Foundation of the Harvard Medical Institutions, Inc., A CRICO Company.

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