Pelberg A L
Qual Assur Util Rev. 1989 May;4(2):39-42. doi: 10.1177/0885713x8900400203.
Sixty-four cases of missed myocardial infarction in the emergency room were identified from the records of a major insurance company. The records were reviewed by three health care professionals using established standards of care for myocardial infarction. The diagnosis of myocardial infarction was missed in many cases due to the lack of diagnostic test ordering, poor interpretation of diagnostic tests, and the young age of the patients. Most patients were presented with symptoms compatible with myocardial ischemia. There was an 83% mortality rate in the 64 cases. The cost of settlement and litigation far exceeded the cost of safe, effective, medical care in the cases studied.
从一家大型保险公司的记录中识别出64例在急诊室漏诊的心肌梗死病例。三名医疗保健专业人员根据既定的心肌梗死护理标准对这些记录进行了审查。由于缺乏诊断检查医嘱、对诊断检查的解读不当以及患者年龄较轻，许多病例中都漏诊了心肌梗死。大多数患者表现出与心肌缺血相符的症状。这64例病例的死亡率为83%。在所研究的病例中，和解与诉讼的成本远远超过了安全、有效的医疗护理成本。
