By Dr. Mercola
Medical mistakes are made in the operating room, in the emergency room and in the doctor's office. And, unfortunately, the mistakes made by doctors, nurses and pharmaceutical companies still are the third leading cause of death in the U.S. Statistics from a study originally published in 20001 have not changed in the 17 years since its publication.
Authors in the Canadian Journal of Surgery believe medical errors represent a serious public health problem and a threat to patient safety.2 The definition of a medical error often rests on patient outcome, or rather if there was a negative outcome from a medication or procedure.
Some research suggests 250,000 people die each year from medical errors and millions more who are harmed by drug-related mistakes.3 However, as frightening as the number of people dying from medical error is, some suggest it is only the tip of the iceberg.4
The purpose of understanding the numbers is not to scare you, but rather to help you understand how you can take control of your health even inside the health care system. Making informed choices and using proven tools to reduce your risk of illness by maintaining optimal health are strategies you may use to reduce your personal risk of injury at the hand of another.
Some medical errors have resulted in drastic changes in the standards of medical care, but often only after tragedies and long years of work to change an ingrained system. For instance, in 1982, ABC highlighted cases of anesthesia mistakes that resulted in injury or death, but it wasn't until 1985 before a program of standardized anesthesia care and monitoring was put into place to avert those errors.5
As a general rule, one of your best ways of preventing unnecessary injury or death is to stay healthy and out of the hospital. This is why I am so passionate about sharing preventive health strategies with you, such as eating right, exercising, reducing stress and getting quality sleep. The exception is in cases of accidental trauma or surgical emergencies when modern medicine can be truly lifesaving.
Survey Reveals 1 in 5 Patients Has Experienced a Medical Error
In a nationwide survey of more than 2,500 people, researchers found that 1 in every 5 adults had been on the receiving end of a medical error and 1 in every 3 said someone whose care they were closely involved in had experienced a medical error.6 The results from this survey found most of the errors were involved with diagnosis of a medical condition and occurred in an outpatient setting. The press release begins:7
"The vast majority of Americans are having positive experiences with the health care system, but 21 percent of adults report having personally experienced a medical error, according to a new national survey released today by the IHI/NPSF Lucian Leape Institute and NORC at the University of Chicago."
Other notable findings from this survey included:
- Almost half of the participants who discovered an error brought it to the attention of medical personnel or other staff
- Most believed that although the medical staff are predominantly responsible for safety, patients and families also have a role to play
- People identified on average seven different factors that played into the medical error
While the survey does demonstrate a willingness to be involved in patient safety, it is also important to note the average rate of error was 21 percent in this sample size, and medical mistakes continue to rank as the third leading cause of death in the U.S. Dr. Tejal K. Gandhi, chief clinical and safety officer and president of the IHI/NPSF Lucian Leape Institute, commented on the results of the study:
"The survey results show that Americans recognize that patient safety is a critically important, but complex, issue. The focus on diagnostic errors and the outpatient settings closely parallels other research in this area and confirms that health care improvers need to take a systems approach to safety that encompasses all settings of care, not just hospitals.
I think one of the most valuable findings is the degree to which patients are willing, and expect, to be involved in their care. The fact that many people who experienced an error spoke up about it confirms that patients and families are vital to informing health care organizations about harm and how to prevent it in the future."
What's Acceptable Human Error?
Any time humans are involved in an equation, there is room for error. No human is error free. And, like most other human behaviors, the average rate of human error has also been picked apart, studied, analyzed and discussed. Human error rate tables confirm that the "human factor" is real and unavoidable. Human performance falters when tasks require great care, or are complicated and nonroutine, in much the same way medical care functions.
However, in most human error rate tables, the highest percentage of error is 10 percent performing complicated, nonroutine tasks.8 Mechanical error rates outside of medical care average 0.5 percent to 1 percent.9 Researchers measured pharmacist error in a busy VA hospital where 1.9 million medications were dispensed over one year and found a 0.0048 percent error rate during the busiest shifts when verification of over 400 medications was done in one eight-hour shift.10
IHS Automotive, an auto industry research firm, reports there are nearly 253 million cars on U.S. roads.11 There are an estimated 5.8 million car accidents each year.12 Of those car accidents, 94 percent are caused by human error.13 If each car drove just once each day, accidents occurring as the result of human error in the 253 million cars is equal to 2.1 percent. Each of these statistics is a far cry from the 21 percent of patients in the U.S. health care system that experience medical errors.
You May Be Shocked by These Medical Mistakes
In many instances, medical error is preventable as it's often the result of human error. Patients and family members may help reduce these mistakes by staying vigilant when receiving medical care.14
• Getting the wrong treatment
To give you medication, radiation, physical therapy or even surgery, medical staff are required to verify your identity. Most hospitals use identification bands with your name, birthdate and a unique barcode. Make sure this is checked before you receive any medication or treatment.
• Waiting in the emergency room
Hospitals and emergency rooms have a finite amount of space, so when they are full, you may be forced to wait for medical care. Most hospitals will prioritize patient care based on the extent of the trauma or urgency of the medical situation. Be sure the staff is aware of any changes to your medical condition while you're waiting.
• Waking up during surgery
If you receive an underdose of anesthesia, your brain may be "awake" even if you can't move your muscles. Unable to move or speak, you may still feel the surgery taking place. Express any concerns you have with your surgeon and anesthesiologist before surgery, including asking about options for local anesthesia in lieu of being put to sleep.
• Surgical mistakes
Surgeons may perform a procedure on the wrong body part, or leave a "souvenir" inside. Between 2005 and 2012, nearly 800 instruments were left inside patients after surgery, drastically increasing their risk for infection and necessitating a second surgery.15
This number doesn't include other potential objects, such as sponges or electrodes. Alert your surgeon and attendants you are aware of these issues, confirming with the surgeon the body part on which surgery is planned and asking them to be especially careful when counting instruments and sponges at the end of the surgery.
• Fake doctors
Not all medical mistakes are made by medical professionals. In some cases, con artists pretend to be doctors or therapists to scam you of your hard-earned money. They sell potions, braces or exercise programs advertised to make you healthier, faster, better or prevent surgery without the research or expertise to back up those claims.
CNN gave the example of Sarafina Gerling, who wore a back brace advertised online by a man found guilty of insurance fraud. Gerling thought the brace would help her scoliosis, but it only made the condition worse.
Iatrogenic Infections Result in Nearly 50,000 Deaths Each Year
Iatrogenic (caused by a medical treatment, diagnostic procedure or physician) and hospital-acquired infections kill more people each year than diabetes. Each year 1.7 million are infected at the doctor's office or hospital and 99,000 die from health care-associated (HAI) infections.16 These infections affect up to 10 percent of all patients hospitalized each year and add an estimated $20 billion in additional health care costs.
Also called nosocomial infections, the most commonly acquired in-hospital type of infection include infections in central line IV catheters, urinary tract infections from Foley catheters, surgical site infections and diarrheal illness from Clostridium difficile (C. diff). In many cases, these infections can be prevented using simple handwashing techniques required of hospital personnel when coming into contact with patients.
Unfortunately, many of these infections are triggered by superbugs or bacteria that have become antibiotic resistant. Inappropriate use of antibiotics and overuse have contributed to the development of antibiotic-resistant superbugs, but the largest source of exposure is actually through antibiotic use in your food. Nearly 80 percent of all antibiotics sold in the U.S. are given to livestock to reduce disease and make the animals grow bigger faster.
Residue from antibiotics is then passed along to you in the meat and dairy products you eat. For example, at least 80 different antibiotics are currently allowed and may be detected in cow's milk. The Centers for Disease Control and Prevention (CDC)17 has concluded that as much as 22 percent of antibiotic-resistant illness in humans is linked to food.
Death Certificates Hide the Real Numbers
At this point, no one knows the real number of deaths that may be attributed to medical mistakes as most death certificates do not list the trigger. For example, Dr. Barbara Starfield, author of the Journal of the American Medical Association study that documented a staggering 225,000 deaths from medical mistakes in 2000, was herself a victim. Her husband, Dr. Neil Holtzman, attributed her death to an interaction between aspirin and Plavix, which was not mentioned on her death certificate.18
Researchers from Johns Hopkins Medicine believe these shortcomings in how vital statistics are recorded hinder research and keep the issue out of the public eye. They wrote an open letter to the CDC, calling for medical errors to become a recognizable and reportable cause of death.19 The data analysis showed the coding system used to categorize death certificate data doesn't capture information that may have led to unrecognized surgical complications, inappropriate medications, diagnostic errors or poor judgment.
The inability to capture the full picture of medical errors may stunt research and public knowledge of a problem that continues to grow inside the health care system. The researchers have recommended a number of different strategies that increase transparency following an error and communication within the health care system and with reporting agencies, such as the CDC.
These types of changes may help researchers evaluate the issues and find solutions to reduce patient injury and death. As long as providers and administrators don't acknowledge the severity of the problem, very few corrections are likely to be made. Dr. Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, led the research and commented on the irony in the results, saying,20 "It boils down to people dying from the care that they receive rather than the disease for which they are seeking care."
Staying Safe in the Hospital
In this interview with Dr. Andrew Saul, who has written a book on the issue of safeguarding your health while hospitalized, we discuss the importance of being your own advocate. Once you have walked through your doctor's office door or have been checked into a hospital, you are immediately at risk for becoming the recipient of medical mistakes. You and your family are the best safeguards against experiencing a medical error. This is particularly important for children and senior citizens.
Anytime you are hospitalized, be sure you have a personal advocate present with you to ask questions and take notes. It helps reduce the likelihood of mistakes when someone can ask, "What is this medication? What is it for? Who is supposed to get it? What's the dose? Are there side effects?" Another step you may consider if someone you know is scheduled for surgery is to print out the World Health Organization surgical safety checklist.21
The checklist can be downloaded free of charge here. If a loved one is in the hospital, print it out and bring it with you, as this can help you protect your family member or friend from preventable errors in care. Needless to say, avoiding hospitalization is your safest bet. You may be able to reduce your risk of hospitalization by maintaining optimal health following specific strategies you'll find in my previous article, "Medical Errors: STILL the Third Leading Cause of Death."