Unexpected findings and misdiagnoses in coroner ’s autopsies performed for trauma at the University of the West Indies, Kingston, Jamaica

This study aimed to identify misdiagnoses and missed (unexpected) findings documented during complete coroner ’s autopsies performed for trauma at the University of the West Indies (UWI) and evaluate their influence on patient outcome. We retrospectively reviewed the reports of all coroner’s autopsies performed for trauma, between 2003 and 2012, at the UWI. For each case, we extracted age, gender, traum a type, mechanism and topography, clinical and postmortem diagnoses and hospitalization duration. The data were used to calculate frequencies, proportions and discrepancy rates. 955 coroner’s autopsies were performed during the 10-year period; reports were available for 933. 396 of these were perf ormed for trauma; 365 met the inclusion criteria. 260 (71.2%) of the 365 autopsies had at least one discrepancy. There were 746 clinical and 1118 autopsy diagnoses; 382 were discrepant (372 missed [unexpected] diagnoses, 6 mis-diagnoses and 4 over-diagnoses). The discrepancy rate (misdiagnoses and m issed diagnoses) was 33.8%, and the majority (55%) occurred in patients hospitalized for<1  day. Cardiopulmonary diseases were the most commonly missed diagnoses. The discrepancy rate was intermediate to those previously reported in the literature. The short hospitalization duration in most patients suggests that limited time for clinical investigation may be a contributor to discrepancy . However, increased awareness among clinicians of the common major missed diagnoses should ...
Source: Forensic Science, Medicine, and Pathology - Category: Forensic Medicine Source Type: research