http://www.voiceoftheinjured.com/a-mm-hospital-errors-honesty.html
Medical Errors In America's Hospitals--Should Patients Be Told When They Occur?
Is honesty the best policy for hospitals? Should a hospital patient be told
when an error causes injury?
The nation's hospitals generally answer "No" to these questions. But one
hospital in Kentucky says, "Yes."
Recent newspaper articles provide a fascinating and alarming insight into the
scope of medical errors in hospitals and what the hospitals do when they are
discovered. Excerpts follow.
The Medical College of Pennsylvania Hospital (MCP) is known for providing
advanced medical care.
It is also representative of modern American hospitals in another respect: In
the past decade alone, records show, hundreds of MCP Hospital patients have
been seriously injured, and at least 66 have died after medical mistakes.
The Philadelphia hospital's internal records cite 598 incidents reported by
medical professionals to the hospital administration in the past decade. In
some of those cases, patients or survivors were never told that the injuries
were caused by medical errors.
Amazingly, none of the doctors involved in the incidents was subjected to
disciplinary action.
For patients of all ages, serious injury and death caused by medical errors are
well-known facts of life in the medical community. But they are rarely reported
to the public.
MCP Hospital's records came to light only because of bankruptcy proceedings
last year, when its new owner publicly filed a detailed account of the 598
incidents reported at the facility from January 1989 through June 1998.
Those numbers mirror what is happening across the country. Lucian Leape, a
Harvard University professor who conducted the most comprehensive study of
medical errors in the United States, has estimated that 1 million patients
nationwide are injured by errors during hospital treatment each year and that
120,000 die as a result.
In their study, Leape and his colleagues examined patient records at hospitals
throughout the state of New York. Their 1991 report found that one of every 200
patients admitted to a hospital died as a result of a hospital error.
Researchers say that medical errors reported to hospital authorities represent
roughly only 5 to 10 percent of the number of actual medical mistakes at a
typical hospital.
Contained in the MCP records is a history of one hospital's experience,
providing an unprecedented glimpse into the extent and nature of hospital
mistakes.
The cases run the gamut from benign to fatal, and involve patients whose health
status ranged from young and vital to old and infirm. They include:
Four patients who died after they received too much medication, the wrong
medication, or no medication.
Surgical ``misadventures'' during which patients' organs were punctured or
blood vessels were pierced.
An epilepsy patient who died and another who was left paralyzed on one side
after brain hemorrhages during surgery by inexperienced and inadequately
supervised residents. In those two cases, four doctors at MCP later signed a
letter to a hospital administrator saying mistakes by unsupervised surgical
residents ``resulted in the unfortunate death of one of our patients.''
Two middle-age patients who died after cardiac emergencies -- men who according
to hospital records did not receive proper or timely treatment from
emergency-room residents. One man sat in the emergency room with dangerously
elevated blood pressure for more than seven hours before dying of a heart
attack.
An 18-year-old man who received the wrong type of blood in a transfusion after
an automobile accident, and died after an apparent hemolytic reaction to the
blood.
Eight surgical patients who required second operations to retrieve sponges,
cotton or metal instruments left inside their bodies.
Inadequate intensive-care monitoring, which delayed response to a woman who had
stopped breathing. She suffered permanent brain damage.
Lawyers for MCP, a 400-bed hospital, have consistently denied the hospital's
liability in lawsuits arising from errors. The hospital's own records suggest
that its experience is no different from that of most hospitals in America.
Was it the interns who made the mistakes?
The MCP doctors who treated patients included in the report had a wide range of
expertise. Some were first-year doctors-in-training, or residents, working
under the supervision of attending doctors. Others were veteran faculty who had
graduated at the top of their medical-school classes and are regarded by their
colleagues as among the most competent in their specialties.
Were the negligent doctors disciplined by the state regulators?
None of the 40 doctors involved in some of the most serious mistakes at MCP was
ever subjected to disciplinary action by the state Bureau of Professional and
Occupational Affairs, according to an agency official.
Did the injured file lawsuits seeking compensation?
Because most medical mistakes do not go beyond hospital walls, it is estimated
that only 2 to 10 percent of all cases involving medical error result in
lawsuits.
There were many instances at MCP in which hospital staff did not tell patients
or their relatives about errors in medical care -- errors that staff viewed as
serious enough to warrant informing hospital administrators.
A Kentucky hospital takes the high road when medical errors occur.
In one Kentucky hospital medical errors are not handled like nuclear secrets.
The Veterans Affairs Medical Center in Lexington, Ky., treats medical errors
differently from most hospitals.
The 400-bed hospital does not simply encourage its staff to tell patients and
their families the truth about errors. It has a tough policy that requires
giving the information as soon as possible by aggressively seeking out patients
and families, even after discharge if necessary. Hospital employees actually
persuade the occasional reluctant victim to accept financial compensation.
The VA hospital in Kentucky has learned that doing the right thing can also
mean saving money. By going out of its way to be open and honest with patients
and their families, the hospital has found that it is minimizing its legal
exposure because families are not as angry when they learn of a medical error.
In 1986, the hospital lost two malpractice lawsuits at trial, costing it a
total of $1.5 million in awards. For a government facility that primarily
treats older patients, whose claims usually result in lower damages, that was
an eye-opening sum.
Now, hospital officials begin assembling dossiers and taking testimony soon
after incidents. As soon as they determine that a mistake has occurred, they
notify the patient or family members. If they believe harm has been done,
rather than evade the truth in an attempt to avoid liability, they advise the
family to hire a lawyer and they seek to quickly resolve the problem with a
fair settlement.
The hospital drills its policy into its staff, especially the residents who
train there, seeking to create a culture in which mistakes are acknowledged and
lead to changes that prevent recurrences. Some of the ethics seminars that it
has held for employees have featured patients who were injured by treatment at
the hospital, explaining how honesty reinforced rather than undermined their
trust.
Sadly, Florida hospitals do not generally follow the approach of the Kentucky
VA facility. They treat discovered medical errors as state secrets not to be
shared with the enemy (aka the patient).
As a result, in Florida and the rest of the US it is wise to consult with an
experienced attorney when malpractice is suspected during a hospitalization.
The odds are good that the hospital is not going to approach you with the
facts.
A lawyer skilled in the evaluation of hospital records is able to obtain the
services of necessary experts (usually nurses and physicians with various
backgrounds). Together with these skilled experts the malpractice lawyer
literally dissects the medical chart and related materials looking for the
telltale signs of error or neglect.