Editing Medical error (section)

=== Healthcare complexity ===
Complicated technologies,<ref>{{cite journal |last1=Maskell |first1=Giles |title=Error in radiology—where are we now? |journal=The British Journal of Radiology |year=2019 |volume=92 |issue=1096 |pages=20180845 |doi=10.1259/bjr.20180845|pmid=30457880 |pmc=6540865 }}</ref><ref>{{cite journal |last1=McGurk |first1=S |last2=Brauer |first2=K |last3=Macfarlane |first3=TV |last4=Duncan |first4=KA |title=The effect of voice recognition software on comparative error rates in radiology reports |journal=Br J Radiol |year=2008|volume=81 |issue=970 |pages=767–70 |doi=10.1259/bjr/20698753 |pmid=18628322 }}</ref> powerful drugs, intensive care, rare and multiple diseases,<ref>{{cite journal|author1=Wadhwa, R. R.|author2=Park, D. Y.|author3=Natowicz, M. R.|title=The accuracy of computer-based diagnostic tools for the identification of concurrent genetic disorders|journal=American Journal of Medical Genetics Part A|volume=176|issue=12|pages=2704–2709|doi=10.1002/ajmg.a.40651|pmid=30475443|year=2018|s2cid=53758271}}</ref> and prolonged hospital stay can contribute to medical errors.<ref>{{cite journal | vauthors = Weingart SN | title = Epidemiology of medical error | journal = Western Journal of Medicine | date=June 2000 | volume = 172 | issue = 6 | pages = 390–3 | doi = 10.1136/ewjm.172.6.390 | pmid = 10854389| pmc = 1070928 }}</ref> In turn, medical errors from carelessness or improper use of medical devices often lead to severe injuries or death. Since 2015, 60 injuries and 23 deaths have been caused by misplaced [[feeding tube]]s while using the Cortrak2 EAS system. The [[Food and Drug Administration|FDA]] recalled [[Avanos Medical]]'s Cortrak system in 2022 due to its severity and the high toll associated with the medical error.<ref>{{cite web |title=Feeding Tube Placement Devices Recalled After 23 Patient Deaths |url=https://www.schmidtlaw.com/feeding-tube-placement-devices-recalled-after-23-patient-deaths/ |website=schmidtlaw.com |access-date=February 13, 2023 |archive-date=February 13, 2023 |archive-url=https://web.archive.org/web/20230213205711/https://www.schmidtlaw.com/feeding-tube-placement-devices-recalled-after-23-patient-deaths/ |url-status=live }}</ref>

Complexity makes diagnosis especially challenging.  There are less than 200 symptoms listed in Wikipedia,<ref>List of medical symptoms. 
https://en.wikipedia.org/wiki/List_of_medical_symptoms#Medical_signs_and_symptoms {{Webarchive|url=https://web.archive.org/web/20220126155958/https://en.wikipedia.org/wiki/List_of_medical_symptoms#Medical_signs_and_symptoms |date=January 26, 2022 }}</ref> but there are probably more than 10,000 known diseases.  The World Health Organization's system for the International Classification of Disease, 9th Edition from 1979 listed over 14,000 diagnosis codes.<ref name="k260">{{cite journal | last1=Utter | first1=Garth H. | last2=Atolagbe | first2=Oluseun O. | last3=Cooke | first3=David T. | title=The Use of the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedure Classification System in Clinical and Health Services Research: The Devil Is in the Details | journal=JAMA Surgery | volume=154 | issue=12 | date=2019-12-01 | issn=2168-6262 | pmid=31553423 | doi=10.1001/jamasurg.2019.2899 | pages=1089–1090}}</ref>  Textbooks of medicine often describe the most typical presentations of a disease, but in many conditions patients may have variable presentations instead of the classical signs and symptoms.  To add complexity, the signs and symptoms of a given condition change over time; in the early stages the signs and symptoms may be absent or minimal, and then these evolve as the condition progresses.  Diagnosis is often challenging in infants and children who can't clearly communicate their symptoms, and in the elderly, where signs and symptoms may be muted or absent.<ref name="k570">{{cite journal | last=Emmett | first=K. R. | title=Nonspecific and atypical presentation of disease in the older patient | journal=Geriatrics | volume=53 | issue=2 |year=1998 | issn=0016-867X | pmid=9484285 | pages=50–52, 58–60}}</ref>

There are more than 7000 rare diseases alone, and in aggregate these are not uncommon: Roughly 1 in 17 patients will be diagnosed with a rare disease over their lifetime.<ref name="u708">{{cite journal | last1=Ronicke | first1=Simon | last2=Hirsch | first2=Martin C. | last3=Türk | first3=Ewelina | last4=Larionov | first4=Katharina | last5=Tientcheu | first5=Daphne | last6=Wagner | first6=Annette D. | title=Can a decision support system accelerate rare disease diagnosis? Evaluating the potential impact of Ada DX in a retrospective study | journal=Orphanet Journal of Rare Diseases | volume=14 | issue=1 | date=2019-03-21 | issn=1750-1172 | pmid=30898118 | pmc=6427854 | doi=10.1186/s13023-019-1040-6 | doi-access=free | page=69}}</ref>  Physicians may have only learned a handful of these during their education and training.