Common misdiagnoses include carcinoma, appendicitis, amebiasis and tuberculosis. As a consequence, EMPD has high rates of misdiagnoses and delayed diagnoses. Bulimia nervosa and gastroparesis are especially prevalent among the misdiagnoses of rumination. Narcolepsy and sleep disorders are common misdiagnoses. After many misdiagnoses, Joe was diagnosed with adenoid cystic carcinoma in 1998. The HCFA cited patient care violations such as misdiagnoses and medication delays. This is a matter of concern because such misdiagnoses can delay correct diagnosis and treatment. Several misdiagnoses were made before she was finally found to have celiac disease. After several misdiagnoses, she was operated on and survived a bout of ulcerative colitis. Makoto was Jiyuu's mother who died from a doctor's misdiagnoses.