Patient Safety Alert 18: Missed and Delayed Diagnoses in the ED (PDF)

The AMC PSO has recently convened Emergency Medicine Leaders to discuss patient safety issues relevant to the Emergency Department setting, yielding both an in-depth analysis of patient safety issues as well as a look at emerging technologies and new strategies to complement existing patient safety protocols.

Case Study

Participants discussed case studies, as well as emerging technologies and new strategies that are now available to complement existing patient safety protocols aimed at reducing ED adverse events.

An elderly patient presented to a regional ED with a complaint of chest discomfort, self-described as “lung pain.” [...] The patient returned to the ED a few days later and was found to have suffered a cardiac event.


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Study patient safety issues relevant to the Emergency Department setting.

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Patient Safety Alerts

View the whole library of these 1–2 page AMC PSO findings.



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AMC PSO

Our Patient Safety Organization convenes clinical leaders to identify and mitigate emerging risks.
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