Failure to Follow Up on Abnormal Test Results: When Delays Become Medical Malpractice

People rely on the experience and expertise of healthcare professionals to investigate and diagnose medical issues with appropriate urgency. Laboratory tests are routinely ordered to give healthcare providers more information and help them determine why a patient is suffering.

When diagnostic tests reveal an abnormality, patients have the right to be informed of the results and to expect further guidance on what to do.

If a doctor receives abnormal test results and fails to follow up with a patient, a patient’s condition may worsen, or a more serious condition may develop. The medical malpractice attorneys at Lopez McHugh LLP help injured patients collect compensation for harm caused when medical professionals drop the ball.

What is an Abnormal Test Result?

Lab test results are compared to a reference range that is considered ‘normal’ because it corresponds to the results of large numbers of healthy people. Results outside the normal range are regarded as abnormal.

An abnormal test result needs interpretation by a medical professional who considers the result in conjunction with a patient’s overall health to determine what further treatment is indicated. Additional testing may be appropriate, or it may be best to monitor the situation until more information becomes available.

How Inadequate Communication Systems Lead to Avoidable Patient Injuries and Malpractice Claims

In medical malpractice cases, lack of communication is frequently at the heart of a patient’s claimed injury. In a recent study of medical malpractice claims from a national claims database, 49% of claims were due to communication failures.

The study found that most communication failure claims involved miscommunication between providers and patients (53%). The other 47% of the claims resulted from a lack of communication between medical providers.

The subjects of the three most common miscommunications that resulted in medical malpractice claims were:

• Patient contingency plan
• Diagnosis
• Severity of illness

An earlier study, published in 2009 in the Journal of the American Medical Association (JAMA), examined incidents in which providers failed to inform patients of abnormal test results. Researchers reviewed nearly 5,500 random patient records from more than 20 primary care practices for abnormal test results and evidence of patient notification.

The study concluded that failing to inform patients of clinically significant abnormal test results was “relatively common, occurring in 1 of every 14 tests”, though failure rates varied greatly among different medical practices.

These studies reveal that medical providers often fail patients by not communicating critical information due to system inadequacies or neglect.

What Healthcare Professionals Should Do When Abnormal Test Results are Obtained in Pennsylvania or New Jersey

In most cases, the practitioner ordering the testing is responsible for communicating the test results to the patient. The testing facility may also have a responsibility to the patient if the patient has requested the information directly or if the law requires the facility to inform the patient.

Abnormal Test Results in Pennsylvania

Pennsylvania’s Patient Test Results Information Act (Act 112) requires facilities performing outpatient diagnostic testing to report “significant abnormalities” directly to the patient within 20 calendar days. The notice must inform the patient of the abnormal results and that the practitioner who ordered the test has received them.

A significant abnormality is a test result that would cause a reasonably prudent person to seek follow-up medical care within the succeeding three months.

Act 112 applies to all medical imaging except:

• Diagnostic radiographs
• Routine obstetrical ultrasounds
• Imaging performed in an inpatient setting or in the emergency room

The primary goals of Act 112 are to ensure patients are made aware of serious medical conditions promptly and to reduce medical errors. However, a 2021 study on the impact of Act 112, comparing random radiology reports from 300 patients before Act 112 and 300 patients after, found no difference in follow-up failure rates.

Both groups had a 34% follow-up failure rate when a patient was transferred from a generalist to a specialist. When the imaging results were beyond the ordering practitioner’s expertise, the follow-up rate was 24%.

Abnormal Test Results in New Jersey

Patients receiving healthcare in New Jersey have the right to expect to learn the results of any diagnostic testing in a timely manner. The New Jersey Administrative Code requires a practitioner performing testing to “promptly” issue the test results to the referring practitioner and, upon request, to the patient:

• By preliminary verbal report, when immediate follow-up care is indicated
• No later than 3 days after receiving the test results

If the test results indicate abnormalities, they must be “clearly identified” for the attention of the recipient. A patient who has not requested the test results directly from the testing facility must rely on the referring practitioner to convey the information.

When a Healthcare Professional’s Actions Become Medical Malpractice

Though not always an indication of a serious problem, abnormal test results do suggest a need for additional follow-up, which is why it is so important that results be reviewed promptly and the patient receive the information quickly.

Some abnormal test results suggest a diagnosis that requires immediate treatment. Delays in obtaining information can lead to a delayed diagnosis, which may allow a patient’s condition to worsen or an impending disease to develop.

If timely receipt of test results could have prevented or reduced harm to a patient, the provider who failed to follow up and caused additional harm may have committed medical malpractice.

Medical malpractice is a specific type of negligence that applies only to healthcare providers. Patients who claim to have been harmed by what a medical professional did or did not do must demonstrate the following legal elements to have a successful claim.

• The provider had a legal duty to the patient
• The provider did not perform the legal duty adequately
• The provider’s lack of performance caused harm to the patient
• The patient suffered damage as a result of the harm

The legal duties owed to patients by healthcare providers are established by law and by generally accepted medical standards. Failing to follow up on abnormal test results is a clear violation of a provider’s duty to inform a patient, but it is only malpractice if the patient can show harm directly related to the provider’s actions.

If You Suffered Harm Because Abnormal Test Results were not Followed up on and Your Diagnosis was Delayed, the Medical Malpractice Attorneys at Lopez McHugh LLP can Help

Although patients now have greater access to healthcare information than ever before, this does not excuse healthcare providers’ responsibility to ensure patients are informed of diagnostic test results, especially when the results are abnormal.

The medical malpractice attorneys at Lopez McHugh LLP have witnessed families devastated when patients don’t receive vital information about their health. The medical profession needs to do better.  If you were harmed by medical negligence, call Lopez McHugh LLP.