Physicians often fail to inform patients of their tests results—or to document that notification—raising the likelihood of a lawsuit, a recent survey suggests.

“Diagnostic errors are the most frequent cause of malpractice claims in the United States,” wrote researchers at Weill Cornell Medical College in New York City, “and testing-related mistakes can lead to serious diagnostic errors….Failure to inform patients of abnormal results is common and a legally indefensible factor in malpractice claims.”

The team reviewed medical records of 5,434 randomly selected patients in 23 primary-care practices. The researchers identified 1,889 clinically significant abnormal test results and 135 apparent failures to inform, a rate of 7.1% or about of one in every 14 tests (Arch Intern Med. 2009;169:1123-1129).

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That rate ranged in individual practices from zero to more than one in four (26.2%), with practices that followed simple tracking procedures posting the fewest failures.

“We found that very few physicians had explicit rules for managing test results,” said lead author Lawrence P. Casalino, MD, PhD, of the Weill Cornell Department of Public Health. “In many cases, physicians and their staff told patients that ‘no news is good news’—meaning [patients] should assume their [test results] are normal, unless they are contacted. That is a dangerous assumption.”

The study recommends these procedures to ensure patients are kept informed:

  •    Route all test results to the responsible physician, who signs off on them.
  •    Notify patients of all results, at least in general terms, even if the results are normal.
  •    Document the notification in the patient’s file.
  •    Instruct patients to call the office if they are not contacted within a certain amount of time.

“Failure to report abnormal test results can lead to serious, even lethal, consequences for the patient,” Dr. Casalino noted. “The good news is that physicians who use a simple set of systematic processes to deal with test results can greatly lessen their error rates.”