When it comes to medical tests, no news does not always mean good news. It can be dangerous to assume medical test results are normal just because you haven’t heard from your healthcare provider.
A recent study by Weill Cornell Medical College of New York found healthcare providers fail to report over 7% of abnormal tests results to the patients. The study reviewed the medical charts of 5,434 patients at 19 primary care practices. It discovered unreported, abnormal test results for x-rays and other imaging studies, and laboratory tests including blood tests, pap smears, and mammograms. Investigators scoured the medical records for evidence the patient had been informed of the abnormal result in a timely fashion. After finding abnormal results and no evidence of notification, the investigators interviewed the healthcare providers. Many claimed to have informed the patient, though there was no evidence of a communication. Other healthcare providers claimed results were not significant, requiring no patient notification. Investigators found 135 cases of serious abnormalities never reported to the patients. A notification failure leads to a missed diagnosis or a delay in treatment and needlessly endangers the patient.
If abnormal tests results are not reported timely and the patient sustains serious injury, the patient may have a malpractice claim against the healthcare provider for the resulting harms and losses.
Types of Medical Tests
There are two types of medical tests: diagnostic tests and screening tests. Diagnostic tests are performed on patients with possible symptoms or signs of a disease or disorder. Common diagnostic tests are:
- Blood test
- CT scan
- Prenatal test
- MRI scan
- PET scan
Screening tests, by contrast, are performed on patients considered at risk of developing a disease or disorder. Screening tests include:
- Pap smear
- Blood pressure determination
- Cholesterol measurement
- Prostate specific antigen (PSA)
- Blood glucose test
What Are Causes of Healthcare Failures to Inform Patients of Abnormal Results?
“There is a disconnect in many offices, and this is alarming,” explains Lawrence P. Casalino MD who led the Weill Cornell Medical College investigation. Here are a few examples:
A. Computer Medical Tracking Systems
Most often, the notification failures relate to computer medical test tracking systems. Electronic tracking systems use automatic triggers to flag abnormal test results. One problem is an absence of uniformity in defining what is abnormal. Some healthcare providers define abnormal differently than colleagues and when test results are exchanged between electronic systems, abnormal results may be ignored because of divergent diagnostic thresholds. Additionally, tests results can be communicated by typewritten notes and not described in the notes as either normal or abnormal.
B. Lengthy Time Span Between Test and Arrival of the Results
Human error and poor management systems by healthcare facilities cause failures to report abnormal results. Errors commonly occur when a patient is sent out to another facility for testing. The outpatient facility may have a different schedule for completion and issuance of results. They may even arrive weeks after the initial request. The lengthy time gap contributes to a failure to relay abnormal results to a patient.
C. Defining Abnormal Results
Healthcare providers have different specialties and training and the variations result in different definitions of normal and abnormal. For example, a test may be read as “normal” by a medical-resident physician and later “abnormal” by a more experienced physician. Physician and facility differences contribute to notification failings.
D. Volume of Data Being Reviewed
We all experience wait times at healthcare facilities. Some physicians see and treat hundreds of patients each week. The volume of data they are responsible to review for patient safety can be significant and, as a consequence, some may err so abnormal results get lost or overlooked in the shuffle. According to a recent study, each week a typical primary care provider may review 800 blood test results, 40 radiology reports, and 12 pathology reports. In the endless conveyor belt of critically important information requiring review, injures can result when abnormal results are neglected or missed.
Devastating Consequences of Failures to Report Abnormal Results
A physician or healthcare facility’s failure to notify can have devastating consequences.
Stacy, age 21, visits her primary care physician for an annual physical and Pap smear. The results are normal. The next year, she returns for an annual physical and Pap smear. The test is abnormal because it finds glandular cells, a dangerous pre-cancer of the cervix. The physician and facility fail to notify Stacy of the abnormal result and do no more diagnostic testing or start necessary treatment. To add insult to injury, the physician sees Stacy two more times that year and fails to mention the abnormal result or do anything.
With no treatment, the abnormal cells on the cervix multiply, grow to be cancer, and invade nearby tissues. The next Pap smear a year later finds the glandular cell became cervical cancer. It is invasive by that late date, such that no medical treatment can salvage Stacy’s reproductive system. Cancer surgeons remove her cervix and uterus to save her life. The healthcare errors deprive Stacy of every child she could ever have.
Strategies for Protecting Patients from Needless Danger
Five routine procedures will keep patients safer from test reporting failures:
- Route test results to the responsible clinician, not merely a clerical person.
- Always have the responsible clinician sign off on test results.
- Inform patients of all results, normal and abnormal; that way no abnormal result gets missed.
- Document in the medical chart when patients are informed of the test result.
- Instruct every patient to call the office if he or she fails to receive test result by a certain date.
Because failures to notify patients of abnormal results occur, protect your health by diligently following up for results of every medical test. After a test, immediately write the date on your calendar highlighting when a result is expected and when that date arrives call the healthcare provider’s office if you have not received the results.
It can be fatal to assume no news is good news. Take action and follow-up on test results to protect your life.
Buchanan & Buchanan Helps Patients Seriously Injured by Failures to Notify Patients of Abnormal Medical Tests Results
Robert, a 59-year-old man, went to the hospital emergency department because of back and neck pain. The hospital does a chest CT, and it finds an infection in the spine. Without prompt medical treatment, the infection will injure the spinal cord and paralyze the patient. The radiologist reports the abnormal test result to the emergency medicine physician by telephone and by electronic report. But the physician sought the test to rule out a different condition, and ignores the dangerous abnormality. He does not notify the patient or start treatment, and sends him home with pain medicine and muscle relaxers, but nothing for infection. Three months later, an ambulance brings Robert back to the same emergency room as a paraplegic because the untreated infection has destroyed his spinal cord.
Robert is paralyzed below the ribcage because of the emergency medicine physician’s failure to communicate the abnormal test result. He can no longer walk, has no bowel or bladder control, and must depend on others to do everything for him.
What to Do if a Failure to Report Abnormal Results of a Medical Test Injures You
Perhaps you or a loved one was injured because a physician or medical facility failed to inform you of an abnormal test result. Seek legal recourse immediately, any delay can mean losing your right to reimbursement of harms and losses. In Michigan, for instance, a medical malpractice lawsuit generally must be brought by the patient no later than 2 years after the medical error or it is barred forever. In cases involving failure to notify the patient of an abnormal test result, the time for filing a lawsuit may under exceptional circumstances be slightly longer where there is delay in discovery of the error. In rare circumstances, an undiscovered error may be brought within six months of when the patient discovers or should have discovered the error, so long as the lawsuit is filed in court no later than six years after the error happened.
At Buchanan & Buchanan, our combined legal-medical team has decades of experience successfully handling medical malpractice cases, including cases involving failure to communicate to the patient abnormal test results. We have medical and legal professionals on staff to talk with you and promptly review your claim. Our team quickly and efficiently assess the medical facts and takes immediate action to protect your legal rights.