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 setting for malpractice claims.
Methods. We reviewed 180 consecutive malpractice claims submitted by attorneys 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 failure to prevent nonocclusive ischemic infarction for 1. Six claims were closed after ME review and 1 claim involving late diagnosis was settled before trial.
Conclusions. The risk of a malpractice claim is reduced by consideration of computed tomography (CT), angiography, and surgical consultation as soon as a patient is seen whose differential diagnosis includes acute mesenteric ischemia.

The diverse clinical settings in which acute mesenteric ischemia occurs share two attributes: the difficulty in making an early diagnosis and the need to make the diagnosis before infarction. Such difficulties are the setting for malpractice claims. Of 180 consecutive cases referred to an internist for ME review, seven legal actions followed acute mesenteric ischemia. We examined these records to learn more about the claims.