Acute mesenteric ischemia and malpractice claims

Background. Acute mesenteric ischemia can be a difficult diagnosis to make, but delay contributes directly to infarction, and this may provide a setti ng for malpractice claims. Methods. We reviewed 180 consecutive malpractice claims submitted by attorn eys for medical expert (ME) review during the 12 years ending in late 1998. Seven cases involved acute mesenteric ischemia. Results. Alleged failure to make a timely diagnosis was the basis for 5 of these claims, failure to provide anticoagulant protection for 1, and failur e to prevent nonocclusive ischemic infarction for 1. Six claims were closed after ME review and 1 claim involving late diagnosis was settled before tr ial. Conclusions. The risk of a malpractice claim is reduced by consideration of computed tomography (CT), angiography, and surgical consultation as soon a s a patient is seen whose differential diagnosis includes acute mesenteric ischemia.