TY - JOUR T1 - Diagnostic errors in an accident and emergency department JF - Emergency Medicine Journal JO - Emerg Med J SP - 263 LP - 269 DO - 10.1136/emj.18.4.263 VL - 18 IS - 4 AU - H R Guly Y1 - 2001/07/01 UR - http://emj.bmj.com/content/18/4/263.abstract N2 - Objectives—To describe the diagnostic errors occurring in a busy district general hospital accident and emergency (A&E) department over four years. Method—All diagnostic errors discovered by or notified to one A&E consultant were noted on a computerised database. Results—953 diagnostic errors were noted in 934 patients. Altogether 79.7% were missed fractures. The most common reasons for error were misreading radiographs (77.8%) and failure to perform radiography (13.4%). The majority of errors were made by SHOs. Twenty two diagnostic errors resulted in complaints and legal actions and three patients who had a diagnostic error made, later died. Conclusions—Good clinical skills are essential. Most abnormalities missed on radiograph were not difficult to diagnose. Junior doctors in A&E should receive specific training and be tested on their ability to interpret radiographs correctly before being allowed to work unsupervised. ER -