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Medical
Errors
The Institute of Medicine (IOM), reports that as many as 98,000
Americans die each year and another 1,000,000 are injured as
a result of preventable medical errors that cost the nation
an estimated $29 billion. In its comprehensive book titled "To
Err Is Human," the IOM recounts two studies which reported
on adverse events.
The Harvard Medical Practice Study reported on more than
30,000 randomly selected discharges from 51 randomly selected
hospitals in New York in 1984. In 1992, a study of adverse
events in Colorado and Utah reviewed a random sample of 15,000
discharges from a representative sample of hospitals in these
two states.
In its study, the IOM reports that some estimate that the
98,000 annual number likely underestimates the occurrence
of preventable errors because (i) it only considered hospital
errors and not errors in other medical settings (ii) it only
considered certain more serious injury cases and (iii) the
study imposed a very high threshold to determine whether an
error occurred.
In another study contained in the IOM's report, 45.8 % of
1,047 patients admitted to two intensive care units at a large
teaching hospital were identified as being the victim of an
inappropriate decision when an appropriate alternative could
have been chosen.
In another published study of 182 deaths caused by three
conditions (heart attack, pneumonia, and CVA or stroke), in
12 hospitals, it was found that at least 14% and possibly
as many as 27% of the deaths might have been prevented. According
to the IOM, a separate 1991 analysis of 203 incidents of cardiac
arrest at a teaching hospital found that half of the 14% that
experienced a complication could have been prevented.
Three years after the IOM published "To Err Is Human,"
the IOM reports that little has been done to reduce death
or injury in this country. Shortly after the release of the
report, Congress held hearings and set aside $50 million for
research into the causes of preventable medical mistakes.
The IOM reports that one reason for the lack of progress since
the release of the report is fierce resistance by doctors
and hospitals to bills requiring mandatory reporting.
Michael L. Millenson, a visiting scholar at Northwestern
University and author of the 1997 book "Demanding Medical
Excellence," observes that many doctors refute the report's
central thesis that mistakes are numerous and affect all players
in the increasingly dysfunctional health care system. And
most resist the notion that hospitals' faulty systems need
to be overhauled to guard against errors that can result from
anything short of perfect performance by individuals.
"You won't believe the number of times I've heard a
doctor say, with a straight face, 'I don't make mistakes,'"
said Millenson. "There's an old saying in aviation: The
pilot is the first one at the scene of an accident. Well,
in medicine, if someone makes a mistake, who gets hurt? It's
not the doctor. Who pays? It's not the Hospital. Nobody's
doing this on purpose, but they're not losing money on it,
either."
The IOM reports that because only a minority of states require
that serious errors be reported, it's impossible for experts
to figure out how to prevent them in the future. IOM panelist
Arthur Levin states: "We can't even count the errors,
so we don't have any more real information than we had when
we wrote the report."
The Cochran Firm - Dallas, L.L.P.
Turtle Creek Centre, Suite 1400
3811 Turtle Creek Boulevard
Dallas, Texas
75219
phone:
214.651.4260
| fax: 214.651.4261
Edward H. Moore is Board Certified, Personal Injury Trial Law. Unless otherwise noted, not certified by the Texas Board of Legal Specialization.
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