Misdiagnosis is a widespread problem in American healthcare generally. However, the problem can disproportionately affect women, both because women are more likely than men to receive erroneous diagnoses or delayed diagnoses for conditions of all kinds and because conditions that occur solely or primarily in women are especially likely to be misdiagnosed. Failures to monitor for and aggressively treat pregnancy-related issues contribute to the consistently high maternal mortality rate in the United States, while the roughly decade-long journey from symptom presentation to diagnosis for endometriosis patients substantially alters earning potential, fertility prospects, and daily quality of life for numerous women across the country each year. Meanwhile, misdiagnosis of ovarian cancer as a variety of far more benign conditions is a leading cause of delayed treatment, with grim results for patients’ five-year survival rates.
The high stakes of misdiagnosis are clear, and the prevalence in women’s healthcare is concerning. If you have suffered, or watched a loved one suffer, as the result of preventable adverse outcomes – up to and including wrongful death – your story, or your loved one’s story, deserves to be told. At Erin Marshall Law, we are committed to spreading awareness and increasing accountability throughout the healthcare system. Call our New Mexico office at (505) 218-9949 today to schedule a consultation to discuss the impact misdiagnosis has had on your life.
Diagnostic Error Rates in Women’s Healthcare
A 2014 available to the public through the National Library of Medicine found that roughly 12 million adults seeking outpatient care in the United States were misdiagnosed annually. While those figures represent only a small fraction of the total number of outpatient diagnoses issued each year, the study authors estimated that about half of the diagnostic errors had the potential to result in severe harm to patients, and the frequency of misdiagnoses led researchers to conclude that “at least” one in 20 adults nationally is affected by a misdiagnosis over the course of a year – resulting in a relatively high lifetime risk for any individual to experience potentially severe consequences stemming from a diagnostic error.
These statistics by themselves already paint a bleak picture, but the reality is that the risks of diagnostic errors are not evenly distributed across the total adult population of the United States. A January 2024 article in KFF Health News reported that women and minorities were substantially more likely than white men to receive a misdiagnosis, with diagnostic error rates in these groups ranging from 20% to 30% – a frequency dramatically greater than the one in 20 figure estimated to affect the population at large in 2014. The stark difference in diagnostic error rates comes with proportionately greater risks of severe harm to patients who are women, who belong to racial or ethnic minority groups, or – especially – patients who happen to be minority women.
Why Are So Many Women Misdiagnosed?
There is no single consensus explanation for why women are diagnosed at rates significantly higher than their male counterparts, even – as a 2023 study available through the National Library of Medicine (NLM) found – for conditions that affect both sexes at roughly equal rates and that show broadly similar patterns of presentation across patient genders. Implicit bias is widely believed to play a role, as members of racial and ethnic minorities in the United States tend to receive late or erroneous diagnoses more frequently than white patients, regardless of gender. At the same time, there are a number of other potentially complicating factors that can lead to delays in diagnosis and treatment.
Misdiagnosis and Maternity Care
Recognizing the importance of whole patient health should not mean ignoring the very real health risks experienced exclusively by those patients who have the biological ability to conceive, carry, give birth to – or lose – a child. The White House in 2022 called maternal health a “crisis” – and while political offices by their nature may be inclined to dramatize current events in order to garner support for their preferred initiatives, crisis looks apt when read against the backdrop of a June 2024 issue brief from the Commonwealth Fund, which indicates that for the same year the Biden Administration released its White House Blueprint for Addressing the Maternal Health Crisis, the United States saw twice as many – in some instances three times as many – maternal deaths per 100,000 live births as other wealth nations; more than half of the countries compared, according to the report, registered fewer than five maternal deaths per 100,000 live births.
Many factors can potentially contribute to the high rates of maternal deaths in the United States – but their concentration in the postpartum period (accounting for roughly 65% of maternal deaths) suggests that lapsed access to medical care, or lapsed attention from those tasked with providing it, in the weeks immediately after a woman gives birth may play a role. As Yale Medicine indicated in 2023, even when postpartum women recognize that something is wrong and attempt to seek care, the high rates of missed and delayed diagnoses can make it difficult for recent mothers to get timely treatment – with, as one physician quoted in the Yale article notes, potentially “deadly consequences.”
Impacts of Non-Maternal Missed Diagnoses on Women’s Health
As previously noted, patients who are women find their care impacted by misdiagnosis at a substantially higher frequency than men, even for the same conditions and even when the presentation of symptoms is generally similar across genders. In light of this troubling information, it should not be surprising that disorders exclusive to female patients show a high rate of diagnostic errors and missed opportunities for timely treatment, with potentially far-reaching effects that stand to adversely affect the patients’ quality of life.
Endometriosis: The Canary in the Coal Mine of Women’s Health
Nowhere are these adverse effects more clearly demonstrated than in the disturbing length of time it often takes for a patient with even classic, “textbook” symptoms to achieve assessment, let alone treatment, for endometriosis. A case study discussion posted to the Patient Safety Network (a service of the United States Department of Health and Human Services) in 2020 noted that the average time for a patient to be diagnosed with endometriosis after first presenting with symptoms ranges from six to 11 years, despite the condition being relatively common, with the World Health Organization (WHO) suggesting case rates may be as high as 10% of women between menarche and menopause. A medical and maternity care attorney with Erin Marshall Law may be able to help you understand your legal options for responding to a healthcare provider’s failure to investigate the cause of your symptoms.
Misdiagnosis of Ovarian Cancers
Failures to achieve a timely diagnosis of ovarian cancer may be even more important, given the poor five-year survival rates associated with late-stage diagnosis. Tragically, however, misdiagnosis of ovarian cancer is common. Despite hand-wringing within the medical profession about the difficulty of diagnosis in ovarian cancers due to the lack of high-quality screening methods, research suggests that patients presenting with classic symptoms of ovarian cancer routinely have their symptoms attributed to another cause, often without investigation. In a 2000 study available through the National Center for Biotechnology Information, researchers report that 13% of patients who sought treatment for their symptoms prior to being diagnosed with ovarian cancer were told “nothing” was wrong with them. Only 20% of respondents in the same survey were told that ovarian cancer was a possibility, and 30% of patients in the study were actually treated for a condition, pursuant to their symptoms, other than the missed ovarian cancer.
Missed Diagnoses Are Misdiagnoses
These data are even more concerning in light of the consistency in reported symptoms. Although the spread of specific symptoms may seem wide, researchers found that when the symptoms reported by patients responding to the survey were grouped by type, clear commonalities emerged: 77% of respondents reported abdominal symptoms, 70% reported gastrointestinal symptoms, and 58% reported some form of pain. Urinary and pelvic symptoms were also widespread, although with frequencies of under 50%.
Adverse Outcomes for Misdiagnosis of Ovarian Cancer
Among the factors researchers identified as “significantly associated” with delay in accurate diagnosis and therefore treatment were initial misdiagnosis of ovarian cancer as symptoms caused instead by:
- Gastritis
- Irritable bowel (syndrome)
- Stress
- Depression
- No problem
Given that, according to the Ovarian Cancer Research Alliance (OCRA),the five-year survival rate for ovarian cancers drops from 74% for Stage Two to 31% when the cancer is not found until State Four, one conclusion to be drawn from the available data is that a major factor in women’s survival is whether they show up to get help and are instead told either that symptoms such as increased abdominal size and vaginal bleeding are psychosomatic symptoms of nonspecific “stress,” or that nothing whatsoever is wrong with them. Tragically, the implications for misdiagnosis of ovarian cancers as benign conditions falls directly in line with the impacts of diagnostic errors and treatment delays elsewhere in women’s health: Over 80% of pregnancy-related deaths are preventable, according to national data from the Centers for Disease Control and Prevention (CDC).
Seek Advice From an Experienced Legal Professional
The high frequency with which misdiagnosis appears in women’s healthcare is unacceptable. Despite crucial efforts to improve awareness, more advocacy is still needed. Meanwhile, it is vital for patients whose lives have been impacted, in many cases derailed, by a misdiagnosis of ovarian cancer, endometriosis, or another common women’s health concern to know be aware of the legal options that they and their families may have for seeking remedy. Consider reaching out to our compassionate legal team at Erin Marshall Law today at (505) 218-9949 to discuss your situation with an experienced professional.
