Re: Medical Errors.
Re: Medical Errors.
[ Back to Messages
Posted by Betty
on October 12, 2000 at 17:09:21:
In Reply to: Medical Errors. posted by Bill Gilson on October 11, 2000 at 17:11:21:
: As most Americans would, more than 30,000 patients who were admitted to 51 of the hospitals in New York state in a single year expected that the finest health-care system in the world would provide them every chance of recovery.
: For some, the reality was otherwise: 1,133 of the patients suffered injuries caused by medical errors - not their underlying medical conditions. Of those, 154 died from the injuries.
: Put another way, one of every 200 of the patients admitted to a hospital ended up dead because of a hospital mistake.
: Those were among the key findings of the "Harvard Medical Practice Study," published in 1991 in the New England Journal of Medicine. It remains the most comprehensive and rigorous examination of hospital errors ever, while data supporting the findings throughout the country continue to mount.
: "The facts are, we commit thousands of errors every week nationally," said David Nash, associate dean and director of the Office of Health Policy and Clinical Outcomes at Thomas Jefferson University.
: "People get killed every day in hospitals," said Bertrand Bell, a professor at Albert Einstein College of Medicine in New York. "This goes on in every hospital in the United States. The public doesn't see it at all."
: In interviews, top doctors at the University of Pennsylvania, Thomas Jefferson University, Harvard Medical School, Stanford University School of Medicine, the University of California at Los Angeles, and Albert Einstein College of Medicine in New York, said that medical errors are a serious and common problem at hospitals across the country. One reason, they say, is that the culture of medicine is founded on unattainable standards of perfection, and those ideals are reinforced by public expectations.
: "The country spends an awful lot of money making sure cars and airplanes are safe," said David Gaba, a physician and professor at Stanford University. "But this is an issue that's been somewhat hidden because when there's a problem, it's not 100, it's one or two."
: Lucian Leape, a pediatric surgeon and adjunct professor of health policy at the Harvard School of Public Health, who led the 1991 study, said those seemingly small numbers add up to one million people being injured by errors in hospital treatment every year - and 120,000 people dying as a result of those injuries.
: When the Harvard study was published, it received little public attention. But organized medicine went on the defensive. The American Hospital Association disputed the conclusions. The American Medical Association attacked the researchers' methods and findings.
: Medication mistakes represent a leading category of hospital errors, accounting for 19.4 percent of the adverse events in the Harvard study. Among the drugs most frequently at the center of medication errors are insulin, blood thinners and chemotherapy drugs. They are commonly prescribed in chronic conditions that can lead to hospitalization, and have lethal potential.
: The largest number of errors - 48 percent - resulted from surgical treatment. By its very nature, surgery carries risks, some unforeseen and others preventable. Technical mistakes during surgery and wound infections afterward each accounted for roughly 13 percent of the adverse events identified in the study.
: The Inquirer reported yesterday that internal records from the Medical College of Pennsylvania Hospital documented 598 incidents in which mistakes were suspected from January 1989 through June 1998. The confidential information became public as the result of a bankruptcy proceeding involving MCP's former owner. The hospital's experience reflects the events at hospitals across the country, according to national studies.
: The Harvard study found that, on average, there was a 3.7 percent medical error rate at the hospitals in its sample. Other studies have found that only 5 percent to 10 percent of all medical errors are reported to hospital administrators; the remaining 90 percent to 95 percent go unreported.
: At MCP, 140,000 patients were admitted during the period covered in the records. Based on an average error rate of 3.7 percent, 5,180 patients would be predicted to have experienced errors. The MCP records document 598 incidents. That represents about 12 percent of the predicted number of errors, which is consistent with the expectation that 5 to 10 percent of all errors are reported.
: In addition, studies in New York and California have found that hospitals are sued for 2 to 10 percent of their medical errors. On that basis, MCP would be predicted to have faced from 100 to 500 malpractice lawsuits during the decade. The actual number of lawsuits was 266.
: One study, published in part in 1997 in the journal Law and Contemporary Problems, found an overall error rate of 3 percent among 15,000 patients admitted to hospitals in Utah and Colorado. Another study, published in 1995 in the Journal of the American Medical Association, found that medication errors occurred in the care of 7 percent of patients at Massachusetts General Hospital and Brigham and Women's Hospital, major teaching hospitals in Boston.
: The Harvard study examined the records of 30,121 randomly selected patients hospitalized in New York in 1984. Among the adverse events it found, 27.6 percent were judged as having been due to negligence, and 13.6 percent led to death. Adverse events were defined as injuries caused by medical management, not the underlying condition, that lengthened hospitalization or resulted in a disability upon discharge.
: Harvard's Leape recalls that the late W. Edwards Deming, a pioneer in developing systems to improve industrial quality, told him that even a 99.9 percent proficiency rate was unacceptable in most industries. It would result in two unsafe airplane landings a day at Chicago's O'Hare airport; 16,000 pieces of lost mail every hour; and 32,000 checks deducted from the wrong bank account every h