Failure to diagnose an acute thoracic aortic dissection (TAD) represents one of the most catastrophic errors in emergency medicine. Despite being a rare condition—with an estimated annual incidence of 3–4 cases per 100,000 people—its mortality rises by approximately 1–2% per hour after symptom onset if untreated. This white paper examines the intersection of clinical oversight and medical malpractice, focusing on failure to rule in or rule out an aortic dissection during initial emergency presentation. Drawing from clinical literature and legal precedent, it explores diagnostic standards, systemic failures, and medico-legal accountability.
Introduction
An aortic dissection occurs when a tear in the intimal layer of the aorta allows blood to enter the media, creating a false lumen and threatening rupture or organ ischemia. Early recognition is essential, as delayed or missed diagnosis accounts for up to 38% of pre-hospital deaths. In the context of medical malpractice, the failure to consider or exclude aortic dissection in the differential diagnosis of acute chest pain is among the most litigated errors in emergency care.
Chicago Medical Malpractice Lawyers Blog


