Misdiagnoses by Emergency Room Doctors


Unfortunately, emergency room doctors can make mistakes, and failing to correctly diagnose patients can put the patients in worse situations. When an emergency room doctor fails to act according to the proper standard of care by misdiagnosing a patient, he or she may be liable for medical malpractice. This article discusses some conditions that are often misdiagnosed by emergency room doctors.

Heart Attacks in Women  

Heart attack symptoms are different in men and women. Women do not generally experience chest pain and pain down the left arm the way men do, though many doctors continue to recognize chest pain as a main indicator of a heart attack in both men and women. Women are likely to experience the following symptoms: neck, jaw, shoulder or upper back pain or discomfort; unusual fatigue; indigestion, abdominal pain or heartburn; shortness of breath; nausea or vomiting; lightheadedness or dizziness; and sweating. If a women presents at the ER with these symptoms, a doctor may not think that she is at risk of a heart attack, but may think she has indigestion and send her home. In addition, because women may not have the “usual” symptoms, a doctor may not order an electrocardiogram or blood tests. In addition, if an electrocardiogram is done, the doctor or nurse may miss something in the results if they are not paying careful attention. If a woman is sent home from the ER and later suffers a heart attack, the doctor that discharged her may be liable for medical malpractice for failing to properly diagnose her symptoms.

Pulmonary Embolism

A pulmonary embolism happens when an artery in the lung becomes blocked. Generally, the blockage happens when blood clot(s) move to the lungs from another part of the body, such as the legs or arms. Many emergency room doctors misdiagnose patients who end up having pulmonary embolisms. Some of the main symptoms of an embolism are sudden shortness of breath, chest pain (either sharp, or dull and aching), coughing up blood, rapid heartbeat, leg swelling, wheezing, lightheadedness and clammy skin. Pulmonary embolism can be hard to diagnose, especially if the individual has heart or lung problems. There are a number of tests that the doctor can perform, however, to determine what is causing the symptoms including: chest X-ray, lung scan, CT scan and pulmonary angiogram. In addition, the doctor should do tests that detect blood clots such as blood tests, ultrasound, venography and MRI. 

Chest Pain

If a person comes to the emergency room complaining of chest pain, a doctor should determine what is causing the pain. Chest pain is not a diagnosis; it is a symptom. While chest pain is a main indicator of a heart attack, it could be caused by other conditions as well. Cardiac causes of chest pain include heart attack, angina (caused by reduced blood flow to the heart), aortic dissection (a tear in the aorta’s inner layer), pericarditis (swelling of the pericardium, which is a sac-like membrane that surrounds the heart) and coronary spasm. Noncardiac causes of chest pain include less serious things like heartburn, sore muscles, injured ribs and costochondritis (an inflammation of the cartilage that connects ribs to the sternum), and more serious conditions such as pulmonary embolism or a collapsed lung.

Simply sending the person home saying he or she has chest pain is not sufficient. In the ER, a patient complaining of chest pain should have his or her blood pressure, pulse and temperature checked. The doctor should also ask about the type of pain (i.e. sharp or dull), where it is located and if there are any other problems. Additional tests to determine the cause of chest pain include: electrocardiogram, echocardiogram, chest X-ray, stress test, blood test and MRI. 

Abdominal Pain

If an individual shows up at the emergency room complaining of abdominal pain, the doctor should not simply send the individual home. Like chest pain, abdominal pain is not a diagnosis; it is a symptom. The doctor should try to determine the cause of the abdominal pain by asking questions about the type of pain (dull vs. sharp), where the pain is, how long it lasts, what makes the pain feel worse/better and whether there are other symptoms, such as fever, nausea, vomiting, constipation or diarrhea. Abdominal pain can be caused by a number of different things including: appendicitis, ulcers, cholecystitis (inflammation of the gallbladder), hernia, kidney stones, pancreatitis, food poisoning, heartburn or indigestion and bowel problems.

Rectal Bleeding

If a person goes to the emergency room because of rectal bleeding, the doctor should do tests to rule out colon cancer. Just assuming that the bleeding is caused by hemorrhoids is not sufficient. If the person actually has colon cancer and the doctor does not check for that, but rather sends the person home, the person could face serious problems in the future, including possible death.

Misreading of X-rays

If a doctor or radiologist misreads an X-ray, the patient could be sent home with a minor injury that could have been easily treated, but which develops into a major health problem. In some cases, an examining doctor may look at an X-ray because a radiologist is not available. The radiologist may then read it the next day and discover a problem that the treating doctor missed. By that point, the patient has already been sent home untreated and complications may be developing.

Reasons for Misdiagnoses

There are many reasons for misdiagnoses made by emergency room doctors. Doctors in the ER are rushed and have too many patients and not enough time in which to see them, especially in the middle of the night or on holidays when ERs are short staffed. In addition, because of the backlog of patients, patients may be seen by physician assistants who may make mistake that are not caught because supervising doctors sign off on charts without reading them. Further, doctors in emergency rooms may be inexperienced or recent medical school graduates. Some emergency room doctors fail to make differential diagnoses; that is, they get focused on one particular diagnosis and fail look at other possibilities. Failure to take thorough medical histories and to order proper tests are also causes of misdiagnoses in the emergency room.

Information provided by Law Doctors.