One of the most pressing questions in any medical malpractice case is often why the medical malpractice occurred in the first place.

Through investigation and expert consultation, we can come to a solid understanding of just what mistakes were made by medical personnel, when they were made, and how the mistakes contributed to or caused the harm suffered by a victim of malpractice. However, understanding why medical malpractice occurs often requires us to look beyond the medical records and testimony to the psychology behind the medical decision-making process itself.  

In this article, we will discuss several biases and systemic errors discussed in peer-reviewed literature which routinely and adversely affect the medical decision-making process, and which often explain why medical malpractice occurs, whether the malpractice consists of a delayed diagnosis, the prescription of a contraindicated medication, or the failure to appreciate a patient’s symptoms and complaints.

At the Law Office of Alvin F. de Levie, Esq., we have represented individuals and families in cases in medical malpractice cases for decades throughout the Commonwealth of Pennsylvania, including, for example, Montgomery County, Philadelphia County, Centre County, Bucks County, Chester County, Delaware County, Lehigh County, Clearfield County, and Fayette County, to name a few. Our team of lawyers has the expertise, the resources, the experience in handling complex medical malpractice cases and reviewing medical records to determine how and why medical providers, including doctors, physician assistances, registered nurse practitioners, and nurses, make errors and how those errors are sometimes compounded by other medical providers.

Biases and Systemic Errors which Adversely Affect the Medical Decision-Making Process and which Often Lead to Medical Malpractice

• Anchoring Bias: Anchoring bias is the tendency to look too strongly to the patient’s initial presentation too early in the diagnostic process, thereby failing to adjust the initial impression in light of later information. In other words, the medical providers become “anchored” to their original interpretation and diagnosis based on the patient’s initial presentation, blinding themselves to the significance of new symptoms inconsistent with the original interpretation and diagnosis.

• Diagnosis Momentum: Once a diagnostic label is attached to a patient, the label tends to become more “adhesive” with time. In other words, what might have started as a possibility at the initial visit, through the confirmation of intermediaries such as nurses and physicians, gathers momentum until it becomes the definitive diagnosis, and all other evidence and possibilities are excluded. The certainty of the diagnosis does not come by way of confirming evidence, but rather by simply not being questioned by subsequent providers.

• Omission Bias: Omission bias is essentially a tendency towards inaction rooted in the belief that the best option is normally to do less. Re-evaluating the medical situation and considering more intervention, particularly when subsequent providers of the same healthcare system become involved, is seen as “rocking the boat” and changing/challenging the decisions of prior care providers within the system.

• Overconfidence Bias: This is the tendency of medical providers to believe they know more about a patient’s situation than they actually know based on evidence, placing too much emphasis on “hunches” and opinion, thereby making a decision with incomplete information.

• Premature Closure: This is a powerful medical decision-making bias accounting in the literature for a high proportion of missed diagnoses. It is the tendency to apply premature closure to the decision-making process, accepting a diagnosis before it has been fully verified. In other words, once a diagnosis is made, the thinking stops, and all future facts are squeezed into that diagnosis, rather than the diagnosis changing based on future facts.

•  Vertical Line Failure: This is the tendency to think in vertical “silos.” That is, to use predictable, orthodox, vertical thinking that emphasizes economy, utility and stacking one fact on top of another rather than thinking laterally and “outside the box.” According to the literature, due to its economy and utility, vertical thinking is usually rewarded by healthcare systems to the detriment of lateral thinking, which would cause the providers to ask themselves questions such as “what else might this be” when dealing with a patient.

All of these biases and decision-making failures help to explain how medical malpractice occurs when simple malice or intentional conduct is missing. After all, in many cases, the situation is not the result of an evil individual intentionally seeking to do harm (though those cases do exist), but rather the negligent or even reckless conduct of one or more individuals whose continued mistakes have catastrophic results.

These biases and decision-making failures also represent well-known and researched routines, patterns, and system-wide failures that must be addressed by individual providers, hospitals, and larger healthcare networks in order to provide standard of care treatment to patients and to avoid medical malpractice. Failure to adopt proper policies, procedures, guidelines and training to counter these well-known biases and decision-making failures may expose the providers and their employers to even greater liability.

What Should YOU Do If You, A Loved One Or A Friend Suffers Injuries or Death Caused by Medical Malpractice?

YOU SHOULD CONTACT MY OFFICE IMMEDIATELY.

Medical malpractice cases are incredibly complex and require an extraordinary amount of investigation. Your attorney may need to obtain and review thousands of pages of medical records, which will then need to be reviewed by an expert. This is an expensive and time-consuming process that must begin as soon as possible to determine whether you have a claim. You also need an attorney with a thorough knowledge of the practice of medicine and the resources and experts necessary to take the case to trial, if necessary.

At the Law Office of Alvin F. de Levie, Esq., our team of attorneys has decades of experience representing individuals and families injured due to medical malpractice. We have handled medical malpractice cases throughout Pennsylvania: From Philadelphia and the surrounding counties to Centre County, from Central Pennsylvania to Pittsburgh, and from the New York border to the borders of West Virginia and Maryland. If you have suffered an injury or someone died as a result of medical malpractice, please call our firm – 24 hours a day, 7 days a week – at (215) 696-3900 for a consultation. One of our team members will be in immediate contact with you. We maintain offices throughout Pennsylvania in Philadelphia, State College and Bellefonte. We are willing to meet any clients throughout the Commonwealth.