Pathology Errors - Medical Malpractice Lawyer
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Pathology Errors Overview
When a patient has a disease like cancer, the treatment and thus the cure can only be achieved if the pathology report has been accurately performed and prepared. Hundreds of pathology slides can cross the desk of a busy pathologist every day and they must all be prepared, read and reported accurately. A number of people are involved in getting this right, from the person who collects the tissue to the person who prepares the report.
In cancer pathology reports, errors are inevitable. In gynecological cancer cases, the rate of error was found to be between 1.79 and 9.42 percent, depending on the study. In cases that were not gynecological, the rate of error was found to be between 4.87 and 11.8 percent. In one study, the differences between errors were found to be related to the institution doing the path reports, errors in misinterpretation, and to clinical sampling. When looking at the errors in gynecological path reports, a total of 45 percent were associated with patient harm. In non-gynecological errors, 39 percent were associated with patient harm.
The errors in pathology reports can be numerous. It all starts with the doctor who collects the samples. If the doctor does not biopsy the proper part on the patient's body, the pathology report can come back negative for cancer when cancer was actually there. This is where certain tumor stains can be created that highlight areas of cancer. This is done when looking at dysplastic areas in cervical cancer. The stain is swabbed on the cervical tissue and it shows up areas of staining where the dysplastic cells are located. Rather than simply looking at questionable areas of tissue, the staining can direct the surgeon or gynecologist where to go when collecting biopsy samples.
The lab tech must log the samples into the laboratory under the proper name and the proper location on the body. Then the samples must be promptly frozen and sliced onto laboratory slides. If the tissue is allowed to sit at room temperature too long, it can degrade and the effective appearance of the slide at the end of the processing period will just show degraded cells. Cancerous cells will be missed in the process. The slides, too, must be properly labeled so that they belong to the right person. The slides must be connected to the right paperwork so that the entire package gets to the pathologist for reading.
When the pathologist gets the slides, they are looked over carefully. One slide is compared to another. The pathologist will have attended many years of schooling and residency in order to become skilled in reading slides. Each pathologist will, however, have his or her special skills in gynecology, GI pathology, skin pathology, brain pathology and general pathology. Some specialists will have a special talent for diagnosing certain diseases. In some cases, slides come in from around the world with different staining techniques for the pathologist to examine. His or her skills in identifying a specific disease can make the difference in whether or not the patient gets the proper diagnosis or not.
There is a thing called inter-reader variability and this means that two different pathologists will see the same slide and will read it different from one another. Some types of slides will have a greater degree of variability due to the nature of the tissue and the way it was prepared. The two pathologists must get together and make a decision as to what the slide means.
There are paperwork errors to be found all over pathology. Each laboratory needs a specific system so as to reduce the amount of error in the system.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here