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Diagnostic errors with inserted tubes, lines and catheters in children
Isabel Fuentealba1, George A Taylor
1Department of Radiology, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA.
Pediatric Radiology
|August 14, 2012
Summary
Diagnostic errors involving medical devices in children are uncommon but can significantly impact patient care. Identifying high-risk situations is crucial for improving outcomes in pediatric patients.
Area of Science:
- Pediatric radiology
- Medical device safety
- Diagnostic error analysis
Background:
- Medical tubes and catheters are vital in hospitalized children.
- Diagnostic errors related to these devices in pediatrics are understudied.
Purpose of the Study:
- To determine the frequency and types of diagnostic errors associated with inserted medical devices in pediatric patients.
Main Methods:
- A 9-year retrospective review of 142,041 cases.
- Identified 50 diagnostic errors related to various tubes, catheters, and wires.
- Classified errors by type (perceptual, cognitive, system-related, unavoidable) and clinical impact.
Main Results:
- Device-related diagnostic errors constituted 1.2% of all discrepancies.
- Vascular catheters (34%) and non-vascular catheters (54%) were most frequently implicated.
- Common errors included incorrect catheter tip location and missed device migration.
Conclusions:
- Device-related diagnostic errors are infrequent in pediatric patients.
- These errors can significantly affect patient management and outcomes.
- High-risk factors include complex anatomy, poor image quality, and incomplete study reviews.
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