About 98,000 Americans are dying from medical errors each year. Such an appalling statistic is the equivalent of one jumbo jet plane crash per day.
The blatant truth of the matter is that we never hear it in quite such harsh terms. The adverse events are cleverly watered down to the generic term "unexpected complications," but clearly some of them are preventable.
Recently, ABC's newsmagazine show "20/20" highlighted some horrific examples. One of the many mishaps was one man who had his left leg amputated when it should have been his right one. One woman underwent a double mastectomy when there was no cancer present. It wasn't a misdiagnosis, but a confusion of two patients' medical records. Another died as a result of an overdose in chemotherapy.
The most dangerous place in the hospital is the operating room. In one case, a man complained of severe pain for over five years after his operation. Despite being told repeatedly that he was "making it up," a 13-inch-long metal retractor, a surgical instrument, was eventually retrieved from his abdomen. In another case, a woman discovered a bulge on one side of her stomach after her surgery and experienced severe pain and infection. Doctors dismissed her complaint as a vanity obsession. She died 11 months later from infections resulting from the 30-by-16 inch surgical towel embedded in her stomach. The doctor was fined $1,000 and forced to serve five hours of continuing education.
According to "20/20," over 15,000 people have walked out of surgery with something left inside of them. It used to be the operating nurse's job to account for all the sponges, needles and towels, etc. But with the shortage of some 300,000 nurses, this responsibility has fallen to the prudence of the individuals performing the surgery.
Obviously all the sensationalized cases tend to fall into the hands of the press. Nevertheless, simple mistakes such as errors in communication, administration and management have prompted President Clinton to announce that "too many families have been the victims of medical errors. They are avoidable mistakes which are preventable and tragedies therefore which are unacceptable."
Unlike the aviation industry and the petrochemical industry, relatively little analysis has been done on medical error. Each week, all hospitals, including the University Hospital, hold a mortality and morbidity conference, to confidentially discuss adverse outcomes and preventative solutions. The analysis is usually qualitative and little quantifiable data exists.
In 1994, the Harvard Medical Practice Study did in fact publish the results of a population-based study in New York. According to an article written by Lucian L. Leape of the Harvard School of Public Health, in the book "Human Error in Medicine," nearly four percent of patients hospitalized in New York in 1984 suffered an adverse event - an unintended injury caused by treatment resulting in prolongation of hospital stay or disability at the time of discharge. For New York State this amounted to 98,600 injuries. The most common types of errors were in diagnosis and technical errors. Of the adverse events, 48 percent arose from operative procedures and 74 percent of these were considered preventable.
Unsurprisingly, 90 percent of patient falls and system failures were considered preventable. Leape's studies showed that patients with preventable adverse events were more likely to suffer prolonged disability or death than those with non-preventable adverse events, and, in fact, death was 60 percent higher for the preventable cases. It was estimated that about seven percent of all adverse events were fatal and preventable. Extrapolating, the number of preventable deaths for the United States would be approximately 100,000 - still twice the annual highway death rate.
Undeniably, certain errors are egregious and negligence accusations should ensue, but the vast majority can be attributed to minor slips, memory lapses and stressful environments. To err is human, and good doctors should not be blamed for such natural mistakes, but clearly there is something wrong when an industry devoted to saving lives and improving health has the highest rate of misadventure on record. And to you and me, the ordinary person, a pure and simple mistake costing our lives is not just unforgivable - it is criminal.
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