Pelletier L L, Klutzow F, Lancaster H
Department of Internal Medicine, University of Kansas School of Medicine, Wichita.
J Gen Intern Med. 1989 Jul-Aug;4(4):300-3. doi: 10.1007/BF02597401.
To determine whether autopsies improve the detection of major clinical errors.
Retrospective chart review of all deaths for a 30-month period to detect major clinical errors when a correct diagnosis and institution of proper therapy would have prolonged the patient's life, with comparison of autopsied patients with those without an autopsy.
Small government hospital inpatient medical service.
335 consecutive deaths with 141 [42%] autopsies.
Review of the clinical records of cases without autopsy led to the discovery of only two major clinical errors [1%], whereas 19 major clinical errors [13%] were detected in autopsy cases. Three of the 19 errors in autopsy patients would have been detected by chart review alone. Thirteen of the 19 clinical errors in autopsied patients were related to infections that were missed or were not treated appropriately because of misdiagnosis.
Autopsies continue to reveal unanticipated and important information that is essential for internal medicine residency training and for the evaluation of the quality of medical care.
