When we seek medical treatment, we do so with the faith that everything will work out. Unfortunately, that is not always the case. Research involving wrongful death from medical errors has been incomplete mainly because the Centers for Disease Control and Prevention (CDC) rely on billing codes to determine the causes of patient death. That method does not reveal medical errors, and these events went untracked. However, a recent study shows a sobering fact; medical errors are the third-leading cause of death in the U.S., following heart disease and cancer.
What Causes Medical Errors?
According to a Johns Hopkins study conducted by Dr. Martin Makary, medical errors result in more than 250,000 preventable deaths per year. While that figure is overwhelming, it could be much worse; other studies indicate the number of U.S. deaths in healthcare settings is as high as 440,000 per year.
There are two reasons why medical error data is challenging to collect. One, cause of death data primarily relies on billing codes. Therefore, the CDC only receives data regarding diseases, morbid conditions, and injuries. Obviously, there are no codes for human error. The researchers suggested that the CDC collect statistics based on death certificates--not billing codes for final illnesses.
Second, the medical profession maintains a wall of silence around medical errors. While most people enter medicine with noble intentions, the truth of the matter is U.S. hospitals are frequently understaffed. The result is physician order backlogs which encourage rushed decision-making that is often not in a patient’s best interest. Many healthcare systems also face shortcomings in technology that should make healthcare workers’ jobs easier.
The most common adverse events leading to medical errors are:
Diagnostic errors: Misdiagnosis or underdiagnosis account for 40,000 to 80,000 hospital deaths per year. This error is most common in primary care settings where doctors fail to order tests, refer to specialists, follow up with patients, or interpret test results correctly.
Unnecessary tests or treatment: Overdiagnosis is also an issue. Patients may receive unnecessary surgeries or treatments that diminish their immune systems, mobility, and overall quality of life.
Medication errors: Patients may receive too much medication or a drug that causes allergies. Also, medication storage errors cause patients to receive the wrong medication. Other errors arise from lack of pharmacist involvement; in one case, a young girl died after a pharmacy technician compounded her intravenous bag incorrectly.
Delayed treatment: Delayed treatment is the third most common medical error, according to health statistics. It frequently involves physicians assigning a benign diagnosis to more serious conditions. Patients face higher mortality rates and more healthcare costs due to readmission and additional treatment.
Failure to follow up: While this is often associated with misdiagnosis, healthcare workers can also fail to follow up even with a correct diagnosis. That includes higher medical expenses due to needing more invasive care. Patients then fail to receive the care they need and face delayed treatment consequences. This error also includes failure to inform; for example, cardiovascular patients often need to reduce physical activity. If they do not do so, they face death or hospitalization.
Surgical errors: Around 4,000 surgical errors occur each year. They include treating the wrong body party, accidental hemorrhage, and anesthesia miscalculations. New robotic surgical techniques increase hemorrhage and laceration risks. These incidents are common hospital errors.
Failure to communicate: Uncoordinated care is a problem even as technology seeks to solve the problem. Sometimes, the error is as simple as a primary care provider failing to read a specialist’s report on a patient. Other times, technology shortcomings, including network breakdowns, make it impossible for health care providers to stay in contact. The result is often conflicting care, including prescribing medications that interact poorly.
Healthcare-acquired infections:The Journal of Patient Safety determined hospital-acquired infections are the leading cause of death for hospital admissions. These can be diseases like COVID or staph infections, but also wound infections after surgery. They arise mainly from poor sanitation processes in hospitals.
Reduced staffing: As the pandemic revealed, many hospitals are understaffed, and healthcare workers face pressure to resolve cases quickly. This situation impacts patient health by discouraging thoroughness and leading to under or misdiagnosis. It also contributes to unqualified staff members taking on duties beyond their education and experience. One example, stated above, is pharmacy technicians handling medication rather than pharmacists.
Racial bias: Explicit bias and structural racism in our healthcare system lead to medical errors and death. In its report on patient safety concerns, the ECRI (formerly known as the Emergency Care Research Institute) reveals Black adults are 50 percent more likely to die from stroke than white adults. Also, during the COVID pandemic, Hispanic and Latinx patients compromised 32.5 percent of deaths, even though they are only 18.5 percent of the population. These studies revealed that healthcare workers are less likely to take health complaints seriously if they come from non-white patients. That leads to medical errors like misdiagnosis, delayed treatment, and others.
The Cost of Medical Errors in Healthcare
Medical errors account for $4 billion in costs each year. The expenses include additional treatment to cover the errors. Also, many errors lead to new injuries arising from surgical, diagnostic, and medication errors, increasing healthcare costs.
Top Ten Patient Safety Concerns
The ECRI compiled a study of the top tent patient safety concerns for 2021. Many of these concerns relate to the pandemic; however, they apply to most healthcare settings even when there are no pandemics. The pandemic merely emphasized them.
The top patient safety concerns include:
Racial and ethnic disparities in healthcare: As discussed, you are more likely to face the impacts of medical error if you are not white.
Emergency preparedness in aging services: Natural disasters make managing the most vulnerable difficult. Evacuation, shelter-in-place orders, and modified visitation affect staffing numbers and patients’ physical safety. Falls during evacuation often cause further injury in nursing homes where supplies and equipment are already limited.
Pandemic preparedness: Pandemics create inpatient surges that pressure short-staffed hospitals. This situation increases the chance of preventable medical errors, including diagnosis mistakes and the possibility of healthcare-related infection.
Supply chain interruptions: When hospitals lack critical medical equipment, they improvise. Patients may catch infections from equipment that is not medical grade or face adverse effects from off-label uses. According to the ECRI, 60 to 70 percent of respirators failed to reach the needed 95 percent filtration efficiency. For hospital gowns, 52 percent of them do not meet the lowest protection standards.
Drug shortages: Related to supply chain issues, drug shortages threaten patient health. Without certain drugs, patients face delayed or canceled treatment appointments or fewer options. Sixty-seven percent of drug shortage events lead to missed or delayed medication doses.
Telehealth workflow management: By 2030, healthcare workers will provide at least half of their services virtually. The issues with Telehealth have more to do with technology; poor WiFi accessibility in clinics and hospitals and inadequate translation services often interfere with effective virtual appointments. Also, there are concerns about privacy and proper follow-up care.
Improvised use of medical devices: When medical staff must improve with medical devices, they risk spreading infections or injuring patients. As stated above, this is a supply-side issue that exists even outside of the COVID pandemic.
Methotrexate therapy: Methotrexate treats cancer and autoimmune disorders. It also presents dosage problems. Of the medical errors traced to Methotrexate, 41 percent of them are the wrong dose. Overdoses can be deadly; patients suffer vomiting, mouth sores, severe skin lesions, renal and liver failure, and pulmonary symptoms.
Peripheral vascular harm: Peripheral intravenous catheters (PIVCs) are the most commonly used medical device in hospitals. Unfortunately, misuse leads to burns, leaks, redness, swelling, drainage problems, erythema, and ecchymosis. Patients also develop infections due to improper insertion.
Aerosol-generating procedures: This issue is amplified with COVID. The droplets produced in these procedures spread infectious diseases and place healthcare workers and other patients at risk.
While this situation appears dire, there is more awareness regarding medical mistakes. The Johns Hopkins University School of Medicine study brought new attention to medical errors, and more citizens insist on legislatures passing a patient bill of rights. However, change moves slowly, and many people feel anxious about healthcare treatment. Until lawmakers take this public health threat more seriously, here is how you can take care of yourself when interacting with medical professionals.
How Patients Can Protect Themselves
Avoiding illness and injury from medical errors requires vigilance. While we all want to trust our medical care providers, they are human and make mistakes.
Here are three tips for advocating for yourself in a healthcare setting:
Ask questions: If your doctor will not perform a test or offers a diagnosis that seems alarmist, start asking questions. Inquire about symptoms and treatment. Make sure your doctor presents all options and explains risks and side effects. Research your condition online for reliable background information. While a Google search does not give you the same authority as a medical degree, it will offer a foundation to ask questions and stay involved in your treatment.
Pursue second opinions: Dire diagnoses should demand a second option. Otherwise, you risk facing unnecessary treatment that may injure you in the future. If a doctor seems soft on making a diagnosis, that is also a sign to seek another opinion. You want as much confirmation as possible. Otherwise, you may suffer from delayed treatment impacts.
Bring someone to appointments: See if a friend, family member, or partner can attend appointments with you. Besides moral support, they also act as an advocate. They may consider questions that do not occur to you or remember details that you were too overwhelmed to comprehend. Also, you have a witness if a doctor dismisses symptoms, refuses tests, or fails to look at test results or reports. That makes it easier to seek another treatment provider or if you need to pursue a malpractice claim, provide evidence.
The best thing you can do for yourself during medical upheaval is to remain involved. If something does not seem quite right, investigate it or take the matter to a clinic or hospital advocate. You are entitled to effective medical treatment and should not suffer in silence.
But if your ordeal never improves, or you discover a medical error, a medical malpractice claim may be your best course of action. If you have any suspicion of medical malpractice, it's important to speak to a medical malpractice lawyer as soon as possible to ascertain your rights.
To schedule a free consultation with an experienced medical malpractice lawyer at Jacob D. Fuchsberg Law Firm, call 212-869-3500 today or complete our online form.