Despite Ethics, Medical Mistakes Go Unreported

Article excerpt

Many serious medical mistakes are never revealed, even though doctors are ethically obligated to disclose most clinical missteps, according to researchers at the Johns Hopkins University School of Public Health.

"It's frightening but unsurprising" that "many - if not the majority" - of medical mistakes are kept secret by the perpetrator and by other medical personnel who witness the mistake, said Dr. Albert Wu, associate professor of health policy and management at the School of Public Health and lead author of a report on such mishaps, published in the December issue of the Journal of General Internal Medicine.

"We argue that a physician has an obligation to disclose mistakes that cause significant harm," wrote Dr. Wu, also associate professor of medicine at Johns Hopkins Medical Institutions.

Both Dr. Wu and the American Medical Association recognize many physicians are reluctant to disclose medical errors, fearing such revelations might generate malpractice litigation, increased malpractice premiums, loss of respect or status among colleagues, a loss of referrals or hospital admitting privileges, or even licensure.

"Mistakes have been treated as quasi-crimes for so long that the impulse is not to expose a mistake and to cover it up," said AMA spokesman Jim Stacey. He said the AMA and an offshoot organization known as the National Patient Safety Foundation are taking steps to try to change that practice.

Just how widespread such behavior is remains uncertain, as there are few studies in medical literature that have examined the frequency of physician-admitted mistakes. But Dr. Wu cited earlier research he conducted, which addressed the issue.

In the study, he asked medical residents how often they admitted making major medical errors. The study found that residents told their supervising physician only half the time, and told patients or their families less than a quarter of the time.

Meanwhile, Dr. Wu said, "There is a growing body of research on how frequently mistakes seem to occur."

He cited a well-publicized Harvard study several years ago that attempted to quantify the problem. The study found that in 4 percent of all U.S. hospital stays, there was an "adverse event" caused by a mistake. …