1. BACKGROUND RESULTS DISCUSSION METHODS REFERENCES
Is this really the cause of death (COD)? Studying Miscoding Rate of COD on Cadavers of the Anatomy Course Elias Lawal, Josephine Moyo MBS, PA-C, Attila Molnar MD Department of Anatomy, Ross University School of Medicine, Roseau Commonwealth of Dominica West Indies
BACKGROUND
RESULTS
DISCUSSION
Our preliminary results show that the miscoding rate is about 40% (8 out of 20 cadavers). For example, three cadavers have been identified that had Alzheimer's disease as primary cause of death. Alzheimer is supposed to be a background disease (may be underlying cause) but can not be the primary (or immediate) cause of death. We are currently processing histopathological slides to determine and reinforce our statement on that particular cadavers. Another group of cadavers where the marked COD seemed to be controversial with macroscopic observations belong to a separate group, which was 20% (4 out of 20 cadavers). Some questionable cases can help students to understand the complexity of diseases. For example, an 85-years old woman whose COD was coded as a cerebrovascular accident (CVA) gave insight to the involvement of sclerotic heart valves suggesting endocarditis. Endocarditis possibly being the root of the dislodged infected plaque (underlying problem) causing the CVA.
Medical errors have been a part of the health care system for a long time without recognition of the negative consequences. In several recent studies estimating the mortality rate due to medical errors enormously high. Therefore , there is a need for identifying specific causes of the errors being able to prevent them. Major discrepancies between COD and the autopsy findings during anatomy dissection have been frequently noticed in every semesters. Therefore, the aim of our present study was to compare the coded (COD) cause of death with our macroscopic-, and histo-pathological findings using more systematic approaches.
Currently, medical errors are the third leading cause of death in the US, approx. 251k people a year. Some of the errors noted postmortem reveal misdiagnosis, partial diagnosis or undiagnosed conditions leading to death. It is important to expose medical students in early stage of their studies to the possible solution of that problem. Diagnostic accuracy can only be confirmed during autopsy and the relatively large number of cadavers in our anatomy course is an excellent tool to highlight the significance of avoiding medical errors. During these studies some interesting cases have been found that could raise the interest of several students for further investigations.
METHODS
Cadavers shipped to the Ross University for student based dissection anatomy course have been the subjects of our studies. As the students and faculties step by step have dissected the cadavers, pathologies have been noted, examined, and compared to the coded COD.
Besides the macroscopic pathological observation of the organs in situ have been performed, micro-pathological techniques on selected tissue samples have also been applied.
100%
(20)
REFERENCES
Martin A Makary and Michael Daniel., (2016) “Medical error-the third leading cause of death in the US.”BMJ 353:i2139.
Jena et al., (2001)”Malpractice Risk According to to Physician Specialty” N Engl J Med; 265:
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40%
(8)
20%
(4)