Has your pediatrician misdiagnosed your child?

About half the pediatricians responding to an anonymous survey acknowledged making at least one diagnostic error a month, and just under half said that at least once a year they made errors that harmed patients.

Published in the July issue of the journal Pediatrics, the survey involved 726 academic and community-based pediatricians or pediatric residents practicing in Houston or Cincinnati.

From WebMD:

“Diagnosing viral illness as bacterial infection was the most commonly reported diagnostic error, closely followed by failure to recognize the side effects of medication.”

“In all, 55% of the pediatric residents, 48% of the pediatricians working at academic centers, and 53% of community-based pediatricians reported that they had misdiagnosed viral illness as bacterial infection.”

“Other key findings from the survey included:

  • When asked to identify the reasons for diagnostic process errors, about half of the doctors (48%) cited a lack of information of the patient’s medical history or failure to review medical charts.
  • Just over 40% said failure by the parent or caregiver to seek medical attention in a timely manner contributed to the diagnostic error and 39% cited failure to follow up on abnormal diagnostic lab tests.
  • The pediatricians and pediatric residents cited better access to electronic health records and closer follow-up of patients after initial treatment as strategies most likely to reduce diagnostic errors in pediatric practice.”

For comparison’s sake one team of doctors estimated that diagnostic errors result in as many as 40,000 to 80,000 hospital deaths each year in the United States.

Out of literally hundreds of visits to our pediatrician, I can only think of one misdiagnosis. We thought Walsh had a cold sore that wouldn’t go away. The school nurse told me it was a cold sore and told me to ask the doctor for a certain medicine. We went in and the doctor agreed and treated it. We treated it three times a day for two months and it never went away! My girlfriend who is a dermatologist encouraged me to take him to see a dermatologist because it’s such a specialized field and she was right. The dermatologist said immediately it was eczema and the cream she gave us literally cured it in one night!

What about your pediatrician? Has he or she ever misdiagnosed your child? Was it due to lack of medical history, failure to seek treatment right away or was he or she just plain wrong? Would electronic records have helped?

27 comments Add your comment

jan

June 25th, 2010
7:06 am

The only misdiagnosis in regards to my 3 daughters was with an eye. When she was just a toddler we were told she had lazy eye and so we followed the common remedy by patching her good eye once a day for an hour or two in hopes to strengthen the lazy one. We then moved to Roanoke and she was given and eeg and it showed that she had a birth defect. The nerves never connected and she is legally blind in her left eye. I felt horrible knowing that for almost a year, I was making my daughter walk around the house totally blind. I know there have been worse cases with doctors but even something like this hurts.

Michelle

June 25th, 2010
8:27 am

I can’t think of a time when my son was misdiagnosed. My step-sons have been on occasion. I’m not surprised at these statistics though. If you stop to think of just how many patients go through an office on a daily basis, it would be difficult not to miss something.

As a parent, the best thing you can do is keep a good history for your child (and yourself) and be vigilent in following up with your doctor for concerns. For example, if the doctor told you something should be improving withing 48 hours and it’s a week later with no improvement, go back! Or, if it seems to get worse, call or go back immediately!

Sometimes parents put too much faith in their doctors. They are human and prone to make mistakes just like everyone else. Contrary to belief, they also do not know everything! :o) Ask questions until you are certain you understand what you are being told! Sometimes the doctors talk to you in “medical” jargon and expect you to understand…DUH!

lakerat

June 25th, 2010
8:33 am

Think we have had this topic before, but with all the new bloggers it is good to rehash. Once when my oldest was about 8-9 he got a sore throat (on a Friday night) just as we were scheduled to go on vacation. We took him to a 24 hr. Chilcren’s Healthcare office since we were leaving the next day; they did the rapid strep test and said he was good to go, so we went. When the real culture returned they found out he did indeed have strep and tried calling us at home to give a prescription – only we were in Utah skiing and he was being a trooper despite a severe infection – he is now in med school with hopes that he will not make that mistake, if he ever graduates and becomes a MD!

The younger also once, when he was about 8-9 fell of some bars in a school gym (during school) onto his head. The school called and told us so we took him to the pediatrician. the doc immediately started manipulating his neck, to which the kid screamed out in pain. The MD said “take him to Scottish Rite immediately”..All I could think of on the way down was that the ped had caused further injury and that the kid was going to be paralyzed. All ended up being well and he just graduated from college last month!

But their dad has been malpracticed on more times than they can count (even just 4 weeks ago when a minor finger operation ended up being MRSA BEFORE he even left the surgery center OR – another reason the older son hopes to be a better MD than what he has had to deal with via his family)…

Lori

June 25th, 2010
8:52 am

I remember as a child my sister broke her finger (actually I broke her finger by accident). We went to the minor emergency place, where they took an x-ray. They said it was fine, take some meds for the pain and she’ll be fine. They called back a week later and said, “the REAL doctor came in a looked at the x-ray and determined it was actually broken”. My Mom said “what do you mean the REAL doctor”!!! You can’t really fix a finger a week after it’s broken!

motherjanegoose

June 25th, 2010
8:59 am

@ Michelle…how are you?

I think DOCTORS need to remember:
“they also do not know everything…”

I absolutely respect the intense schooling and learning they have had to endure.

We have been mostly lucky with our children’s Doctors but ( to me) continuity and finding a doctor who is personal, is important. We did use a neurosurgeon ( I think that is correct) when our daughter had Erb’s Palsy. I thought his bedside manner was awful. I mentioned this to our Pediatrician and he replied, ” he is a very focused Doctor and his expertise does not fall in chit chat.” That always stuck with me but for a Pediatrician, I want a bit of a personality.

That being said, my son is rather quiet and we often comment on this as he must be more talkative when he is in the Pharmacy, as everyone seems to really like him and he relates well with his customers. There are certain personalities who choose certain careers.

It has been years since we have been to a pediatrician! I am old enough to remember when the Doctor came to us….LOL.

JATL

June 25th, 2010
9:20 am

@Lori -I had that happen to me about 6 years ago! I went to the Crawford Long ER after suffering an injury to my little finger that left it gaping open in all sorts of grossness, and I was in AGONY -but it was an agony that didn’t seem to just stem from the wound. My husband and several others said they were pretty sure my finger was broken because of the way it looked, but they took xrays and said it wasn’t. I got stitches, went home and went on vacation (my finger hurting a lot all the while). It finally stopped, but when I went by the camp doctor (long story -I was camping in the desert) to have my stitches removed, he looked at it, manipulated a little and said -”You didn’t have a splint or anything with this?” Me -”Uh, no, they said it wasn’t broken -and they took xrays. I asked for a splint because it hurt and they said I didn’t need it.” Doctor, “Well THEY were wrong!” And I have to agree since it’s still “askew” some 6 years later -I have one of those really wonky pinkies you sometimes see on people. SO -while it wasn’t a pediatrician, I think we all need to be very vigilant about our medical care. Doctors make mistakes all the time!

FCM

June 25th, 2010
9:23 am

Medical Offices are called a “practice” for a reason. Yes the medical field is rooted firmly in science and research…but it keeps advancing and new things happen. New things discovered. Then there is the issue that Doctors are human, not gods despite what they think. Why do you think Doctors need malpractice insurance is they are always right?

sknfan

June 25th, 2010
9:31 am

lakerat, the MD @ the 24 hour Children’s Healthcare DID NOT make a mistake. If your child’s rapid strep test came back negative in the office, it is standard of care to send a culture. What they did wrong was to not get a contact number for you in Utah so they could call in an antibiotic when they got the postive result from the culture. It is not standard of care to prescribe antibiotics for every sore throat. Antibiotics are only to be prescribed with confirmed strep. The rapid strep test done in the office has an accuracy rate in the 90th percentile (not perfect).

Becky

June 25th, 2010
9:32 am

Right off I can’t really think of a misdiagnosis from a pediatrician for anything..My nephews wife gave birth to a baby boy at Northside Hospital..She had been in a really bad car wreck and was only (about) 6 1/2 months along..About a week after he was born, they gave him a adult dosage of his meds..He only lived maybe 2 days after that..

My sister is an IV tech for a hospital in DC..She’s all the time telling me stories about how the Drs. mess up patients meds more than we know..

lakerat

June 25th, 2010
9:52 am

Uh – “What they did wrong was to not get a contact number for you in Utah so they could call in an antibiotic when they got the postive result from the culture.” Thanks for confirming that they “did wrong”…if you “do wrong” how can that considered “meeting the standard of care”…

TechMom

June 25th, 2010
10:07 am

Luckily the boy is pretty healthy so we don’t encounter diagnosis- right or wrong, very often. When he was about 3, we thought he had pink-eye. Two other kids at his daycare had it recently and he woke up with really red, swollen eyes. Took him in that day to see a dr. who agreed and wrote a Rx for antibiotic drops. Poor kid had an allergic reaction to the drops and his eyes swelled even more. Stopped giving him the drops and went back the next day to which we were told (by a different dr.) that it was just allergies.

I have been the recipient of a too-busy family practice that doesn’t read their lab reports. I had what I thought was a UTI and was prescribed antibiotics. After a week of worsening pain I went back and saw a different doctor who walks in with my lab results and says, “Oh, well no wonder why. You were given anitibiotics that doesn’t work on this type of infection!” Fabulous, thanks for calling me 3 days ago when you got the lab report. Oh and they still wanted me to pay my co-pay for a follow-up visit. I laughed and told them they could have given me a follow-up phone call to let me know they had called me in a new Rx and not wasted anyone’s time but I wasn’t going to pay any more of my money for their mistake.

motherjanegoose

June 25th, 2010
10:12 am

@ JATL, our son fell off of a ladder, while hanging a banner in the youth group room at church. He hurt his foot but did not want to go to the Doctor. The next day, it was all swollen. We took him in
( on the weekend).

They did xrays and came back in the room. “What is the problem?” We asked. The answer,
” WELL….he has a BIG FOOT!’ Oh really, we have been purchasing shoes for that size 15 for a while and did not need and x-ray to learn about it….LOL. Then, “we need him to see the orthopedic ( sp?) doctor on Monday.” Turns out, he had chipped his little toe. They wrapped it up and gave him pain pills…told him to stay off of it all weekend.

motherjanegoose

June 25th, 2010
10:25 am

Check this out…off topic but related to a previous topic on pets being smuggled into the cabin:

Tiny turtle causes taxiing plane to return to gate

on yahoo

Mom of 2

June 25th, 2010
10:36 am

Everyone in my family has been misdiagnosed at some point! I was recently given antidepressants and then found out my aniexty is really from my thyroid not working. WHy wasn’t I given a simple blood test? My sister went to a family practice with a severe kidney infection. THey kept telling her it wasn’t her kidneys it was her birth control pills. Turns out she finally walked out on the nurse practiioner and tracked down the doctor in the building. The doctor had to argue with the nurse to convince her to send my sister for on ultrasound!She had tumors! My dad had reoccuring bladder infections. After 2 months of antibiotics, he finally got to see the urologist. My dad was diagnosed with prostate cancer! Thank God the specialist could finally see him! My mom was diagnosed with a heart murmur. She doesn’t have one. My son had severe ear infections and I had to show the nurse practioner exactly what an ear infection looked like! She kept telling me it was a sinus infection. My husband has had 7 failed knee surguries and now he can no longer run, squat, or bend his legs with using his hands.

So that’s my experience. I give up!

CDD

June 25th, 2010
10:38 am

Our pediatrician is the best. It’s inconvenient to get to her (45 min. drive there,) but the fact that she can look at my kids and know that they’re “off” in some way is great. I remember when one of my girls got sick when she was 2. Stomach flu I thought but after she wouldn’t keep anything down and having diarrhea, I finally took her in. Dr. looks her over and says, “She’s sick & very dehydrated. You can take her home and try pedialyte, and other home remedies or you can take her to the hospital right now for fluids. I recommend the hospital.” (Maybe not an exact quote but the gist is the same.) Turns out she had rotavirus and was in the hospital for 4 days. This was before they had a vaccination for it.

Now my son, when he was 2, woke up very sick one night. He’d had a cold for a few days but then he woke up with 104.7 fever and I rushed him to the ER. They took x-rays, said he had a virus and sent us home. They told us to do the Tylenol / Motrin route. I do a follow-up with his pediatrician (not the same one we have now – this was about 8 years ago) the next day and he says my son has an ear infection. Then the hosptial calls me the next day to tell me they rechecked his x-rays and he actually has pneumonia. This same hospital, several years later, saw my daughter (same one & same year as the rotavirus) because she’d fallen teeth-first into an entertainment center. Her front two teeth were gone and they said she’d knocked them out. No x-rays, not even a doctor showed up to examine her. Turns out her teeth weren’t actually knocked out but shoved up into her gums. They grew back out within a year.

Becky

June 25th, 2010
10:40 am

@Lori..Had a friend that her mother was carrying her 8 month old baby on her hip..Fell in MacDonalds, onto the baby..Didn’t take her to the Dr. A week later, the baby was still screaming when her diaper was being changed, so she was then taken to the Dr..They said that her leg had been broken, so in order to fix it, they rebroke (sp) it, put it in a cast and 18 years later, shes fine..So, I’m wondering why they couldn’t do this for you?

sknfan

June 25th, 2010
10:52 am

lakerat, the clinical standard of care was met, why so much attitude?

FCM

June 25th, 2010
11:20 am

Becky Dennis Quaid’s twin sons were given the adult dose of the somthing too. That falls more on the nurse than doctor in the Quaid case. The nurse gave the wrong amount but the doctor had perscribed it correctly as I recall. However it happens, or whose fault, it is tragic. The point is that it apparently does happen since it was your family and their’s—or is your nephew Mr. Quaid ;)

I never saw Scottish Rite saying that my daughter (18 mos) had not broken her foot when she had as a mis-diagnosis. That was on a Friday. After a weekend of her sitting holding her foot saying “ow” in a pitful voice, when she would try to walk–so she went back to crawling–I took her to a pediatric orthopedic specialist. She took one look at my daughter and said “she is trying to tell us something, let’s see what.” She blew up the x-ray and sure enough a tiny fissure in her toes was there. We put a cast on her and she literally ran out the door. She climbed in that cast, she ran in the cast, she did everything but get the cast wet. (changing diapers around a cast is no fun). That fissure was so small it couldn’t easily be seen. Since she had just gotten hurt (at day care) that same day the ER could certainly think it was a sprain/strain not a break. However like someone else said, you keep watching the child and if you feel you need a 2nd opinion then go get one!

Michelle

June 25th, 2010
11:29 am

Hi MJG…I doing well. I’m leaving vacation in the morning! Whew…I am SO ready! I wanted to leave tonight, but the little guy wants to go to his soccer practice :o( Oh well, I’m happy that he enjoys it so much!

Not to split hairs, but if you knew you were going on vacation and “might” need a follow up phone call, it is YOUR responsibility (not the clinic) to provide a phone number where you can be reached! The clinic has the responsibility to call the numbers provided. If you gave them one and they called you at home, they didn’t do a good job of reading!

Gross negligence is once thing, making an error is another. Sometimes they are difficult to tell apart!

Lori…LOL…they probably meant the radiologist! The doctors on sight can read x-rays, BUT the radiologists are “specialists” in reading them so they can pick up on the smallest changes in an x-ray whereas a “regular” doctor might miss it!

David S

June 25th, 2010
11:33 am

But remember, thanks to the government granted monopoly that the AMA and state license boards have on who can practise medicine, this problem will never get any better. The elimination of competition from highly qualified professionals (Nurse Practitioners, PA’s, or even fully qualified doctors from other countries) means that the profession has no incentive to get any better. Add to that the FDA restrictions and state restrictions on alternative medicine providers and the traditional doctors are fully insulated against the “ravages” of the marketplace that are making every other service provider better and better.

This is what you get when you rely on government created monopolies and heavy government regulation to supposedly keep you safe. Government intrusion into medicine that began in the early 1900’s has steadily driven up cost and driven down quality.

If you think these statistics are bad, one can only imagine the misdiagnosis that goes on in the field of childhood psychiatry where 2 year olds are being diagnosed with clinical depression and prescribed dangerous and deadly anti-psychotic drugs with no long-term studies and the like. Oh yes, the AMA, the state boards, and the FDA are really keeping you safe.

Becky

June 25th, 2010
11:38 am

@FCM..Yeah, it was the nurse as you said, giving the dosage that thet Dr. had prescribed..This is part of what my sister is always telling me, that the IV techs aren’t suppose to say anything when they know that the scrip is wrong, but a lot of them do..Then of course, it’s the IV techs that get shipped off to do some crappy duty as punishment for trying to do right..

motherjanegoose

June 25th, 2010
11:38 am

When my kids were small, we had their check ups every summer before our vacation. We went to the Pediatrician on Friday morning for our annual.

We flew to the beach on Sunday. On Monday night, our son had a temp. and complained of a sore throat. I called our office on T. They put our Doctor on the line. She called an antibiotic in to a Pharmacy at the beach and told us that if he had not perked up in 24 hours to take him to the ER. We were to come back to the office when we got home.

All worked out well. He apparently did have strep throat.

@ Michelle…have fun!

FCM

June 25th, 2010
11:41 am

@ DavidS you forgot about the new Health Care and Education Act. Med care likely to get worse not better.

Michelle

June 25th, 2010
12:16 pm

UGHH…I hate to see what happens as the health care continues to change!

lakerat

June 25th, 2010
1:54 pm

You guys are right – no worse for the wear – just trying to add to the dialogue but obviously I overstepped the boundary…my bad.

catlady

June 27th, 2010
1:37 pm

Maybe a better topic would be medical mistakes made on your family. I have even been given the wrong medicine at the pharmacy!

catlady

June 27th, 2010
1:59 pm

Or maybe mistakes by the insurance company! I’ve got a boatload of those, too!

When my son had BRAIN SURGERY the state insurance company returned the claim, said they needed to know if the BRAIN SURGERY took place in the hospital or doctor’s office. The insulting thing was they had already paid the 10 days of hospitalization, AND the claim the doctor submitted noted it was in the hospital!

When my son was born they refused to pay the hospital bill (had already paid the OB) because they had reason to believe the hospitalization was due to an auto accident! I told them NO PART of the child’s birth nor conception had anything to do with an automobile!

Same son was playing Jedi Knights with BASEBALL BATS as swords and got his finger hit. Had to have stitches. The hospital billed for, and the insurance paid (until I raised cain) for general anesthesia and a stomach drain!

My mom had radioactive pellets inserted to treat for uterine cancer. The pellets fell out and she lay on them for days and got burned, etc.

Same mom, had heart surgery. One day a pharmacist came in and started telling us how to take her meds when she went home. Only thing was, she was NOt going home, but to a rehab center. When I pointed this out, he realized he was IN THE WRONG PATIENT’S ROOM.

I got put to sleep for removal of my gall bladder and woke up paralyzed. The IV (which was improperly inserted–I watched them insert it by rolling the vein into the needle after they missed the vein) failed to work properly AND I WOKE UP ON THE OPERATING TABLE and they kept giving me more drugs to paralyze me which flowed into my muscles and kept me from being able to breathe. Want to go through hell? be awake, paralyzed, and entubed. Thank God my daughter was there beside me to explain what was happening or I would have literally lost my mind (I am claustrophobic, in addition to everything else).

Most recently, I ran into the vaccum cleaner in the dark and hurt my foot. Went to the dr who sent me to the hospital to get Xrays. The xray readers said no broken bones, so I walked on it for 3 weeks and could not stand the pain. Went to an orthopedist and he showed me the 4 bones that were broken on the hospital xray. Was unable to heal satisfactorily enough to walk at my older daughter’s wedding 4 months later.