Epilepsy Talk

Why you should AVOID going to the hospital… (If You Can!) | January 30, 2023

Medical mistakes are the third leading cause of death in the United States, after heart disease and cancer.

A recent Johns Hopkins study claims more than 250,000 people in the U.S. die every year from medical errors.

Other reports claim the numbers to be as high as 440,000.

The Institute of Medicine, an independent group that advises the government on health matters, led to a national movement to reduce errors and make hospital stays less hazardous to patients’ health.

Among the preventable problems were severe bleeding during an operation, serious breathing trouble caused by a procedure that was performed incorrectly, a fall that dislocated a patient’s hip and damaged a nerve, and vaginal cuts caused by a vacuum device used to help deliver a baby.

Since then, instead of improvements, the researchers found a higher rate of problems.

About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of the injuries were judged to be preventable.

Most of the problems were temporary and treatable, but some were serious, and a few — 2.4 percent — caused or contributed to a patient’s death, the study found.

The findings were a disappointment but not a surprise.

Many of the problems were caused by the hospitals’ failure to use measures that had been proved to avert mistakes and to prevent infections from devices like urinary catheters, ventilators and lines inserted into veins and arteries.

An expert on hospital safety who was not associated with the study said the findings were a warning for the patient-safety movement.

“We need to do more, and to do it more quickly,” said the expert, Dr. Robert M. Wachter, the chief of hospital medicine at the University of California, San Francisco.

A recent government report found similar results, saying that in October 2008, 13.5 percent of Medicare beneficiaries — 134,000 patients — experienced “adverse events” during hospital stays.

The report said the extra treatment required as a result of the injuries could cost Medicare several billion dollars a year. And in 1.5 percent of the patients — 15,000 in the month studied — medical mistakes contributed to their deaths.

That report, issued this month by the inspector general of the Department of Health and Human Services, was based on a sample of Medicare records from patients discharged from hospitals.

The study reviewed the records of 2,341 patients admitted to 10 hospitals — in both urban and rural areas and involving large and small medical centers.

(The hospitals were not named.)

The researchers used a “trigger tool,” a list of 54 red flags that indicated something could have gone wrong.

They included drugs used only to reverse an overdose, the presence of bedsores or the patient’s readmission to the hospital within 30 days.

The researchers found 588 instances in which a patient was harmed by medical care, or 25.1 injuries per 100 admissions.

Although those numbers are sobering, the researchers were more disappointed to see that the rate of errors did not decline over the six years they studied.

Not all the problems were serious. Most were temporary and treatable, like a bout with severe low blood sugar from receiving too much insulin or a urinary infection caused by a catheter.

But 42.7 percent of them required extra time in the hospital for treatment of problems like an infected surgical incision.

In 2.9 percent of the cases, patients suffered a permanent injury — brain damage from a stroke that could have been prevented after an operation, for example.

A little more than 8 percent of the problems were life-threatening, like severe bleeding during surgery. And 2.4 percent of them caused or contributed to a patient’s death — such as bleeding and organ failure after surgery.

A nationally coordinated system is needed to help hospitals put proven safety measures to work, Dr. Christopher Landrigan, a patient safety researcher at both Children’s Hospital Boston and Brigham and Women’s Hospital said — citing surgical checklists, computerized prescription order entry, and limits on how long doctors and nurses can work without sleep.

Electronic medical records help, but not all the safety measures have to be high-tech, he said. One of the most effective ways to prevent hospital-acquired infections is for doctors and nurses to wash their hands.

Dr. Mark R. Chassin, president of the Joint Commission, which accredits hospitals, said, “that preventable complications are way too frequent in American health care,” and “it’s not a problem we’re going to get rid of in six months or a year.”

For the most part, the reporting of medical errors or harm to patients is voluntary, and that vastly underestimates the frequency of errors and injuries that occur.

Leah Binder, the chief executive officer of the Leapfrog Group, a patient safety organization whose members include large employers trying to improve health care, said it was essential that hospitals be more open about reporting problems.

Examples of hospital errors

All of the phases from diagnosis to treatment can have some type of error.

Here is a compilation of different medical mistakes from such organizations as The Institute of Medicine and The National Patient Safety Foundation:

Diagnosis mistakes (Note: there are various mistakes that can cause a misdiagnosis of a condition. Misdiagnosis can be one of the most costly of medical errors, leading to delayed, omitted, or inappropriate medical treatments.

Unfortunately, the wording in the study for misdiagnosis is often “misdiagnosis” or “wrong treatment”, so it’s unclear exactly how many were true misdiagnoses — or a wrong condition treated with the wrong treatment.)

Prescribing errors (68%)
Technical errors (44%)
Misdiagnosis (40%)
Hospital (48%) – account for all errors — including medical procedure error (22%), operating room (7%), emergency room (5%), untrained staff/incompetence (14%),
Medication error (28%)
Carelessness/negligence (29%)
Administration errors (25%)

And HUNDREDS more…

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Resources:

https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

http://www.nytimes.com/2010/11/25/health/research/25patient.html?partner=rss&emc=rss

https://www.psychologytoday.com/us/blog/the-doctor-is-listening/201303/10-medical-errors-can-kill-you-in-the-hospital

https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

https://www.ncbi.nlm.nih.gov/pubmed/28186008

https://www.ncbi.nlm.nih.gov/books/NBK499956

https://www.ahrq.gov/topics/medical-errors.html

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