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| 2.AUTHOR | Rusnak-R-A, Borer-J-M, Fastow-J-S. |
|---|---|
| INSTITUTION | Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis MN 55415. |
| TITLE | Misdiagnosis of acute appendicitis: common features discovered in cases after litigation (see comments). |
| SOURCE | Am-J-Emerg-Med 1994 Jul, VOL: 12 (4), P: 397-402, ISSN: 0735-6757. |
| CM | Comment in: Am-J-Emerg-Med 1994 Jul; 12(4):500. |
ABSTRACT
To
identify differences between correctly diagnosed appendicitis and misdiagnosed
cases that resulted in litigation between 1982 and 1989 retrospective review of
malpractice claims was conducted. A total of emergency department (ED) charts
at the time of the initial ED visit were reviewed and compared with 66 concurrent
controls. Missed cases appeared less acutely ill, had fewer complaints of right
lower quadrant pain, received fewer rectal examinations, received intramuscular
(IM) narcotic pain medication for undiagnosed abdominal pain or symptoms, and
more often received an ED discharge diagnosis of gastroenteritis. Misdiagnosed
patients had a 91% incidence of ruptured appendix, more extensive surgical procedures,
and more postoperative complications. Data were analyzed using the Pearson's chi
2 Test, Mann-Whitney U Test, and stepwise discriminant analysis. Significance
was defined as P
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