Missed Diagnostic Opportunities in Pediatric Hospital Medicine: A Critical Patient Safety Concern
Missed diagnostic opportunities (MDOs) represent one of the most pressing patient safety concerns in pediatric hospital medicine today. As both a pediatric hospitalist at Johns Hopkins All Children's Hospital and an expert witness in medical malpractice cases, I've witnessed firsthand how diagnostic errors can lead to devastating outcomes for children and families. This article examines the scope of the problem, contributing factors, and evidence-based interventions that are making a difference.
MDOs occur when there is a failure to make a timely or accurate diagnosis, often resulting in harm due to delayed or inappropriate treatment. These errors represent the most common medical factor in pediatric malpractice claims and are a top research priority in patient safety.
Cognitive biases such as premature closure and pattern recognition errors are particularly salient in high-pressure environments like the emergency department, where rapid decision-making is necessary but diagnostic uncertainty is high.
Patient Safety · 10 min read · Ralph D. Martello, MD, pediatric hospitalist and medical expert witness.