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Missed Myocardial Infarction in the Emergency Room

The University Hospital, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pennsylvania 17033

Sixty-four cases of missed myocardial infarction in the emergency room were identified from the records of a major insurance company. The records were reviewed by three health care professionals using established standards of care for myocardial infarc tion. The diagnosis of myocardial infarction was missed in many cases due to the lack of diagnostic test ordering, poor interpretation of diagnostic tests, and the young age of the patients. Most patients were presented with symptoms compatible with myocar dial ischemia. There was an 83% mortality rate in the 64 cases. The cost of settlement and litigation far exceeded the cost of safe, effective, medical care in the cases studied.

American Journal of Medical Quality, Vol. 4, No. 2, 39-42 (1989)
DOI: 10.1177/0885713x8900400203


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