Magazine article FDA Consumer

MAKE NO MISTAKE!: Medical Errors Can Be Deadly Serious

Magazine article FDA Consumer

MAKE NO MISTAKE!: Medical Errors Can Be Deadly Serious

Article excerpt

Two months after a double bypass heart operation that was supposed to save his life, comedian and former Saturday Night Live cast member Dana Carvey got some disheartening news: the cardiac surgeon had bypassed the wrong artery. It took another emergency operation to clear the blockage that was threatening to kill the 45-year-old funnyman and father of two young kids.

Responding to a $7.5 million lawsuit Carvey brought against him, the surgeon said he'd made an honest mistake because Carvey's artery was unusually situated in his heart. But Carvey didn't see it that way: "It's like removing the wrong kidney. It's that big a mistake," the entertainer told People magazine.

Based on a recent report on medical mistakes from the National Academy of Sciences' Institute of Medicine, Carvey might fairly be characterized as one of the lucky survivors. In its report, To Err Is Human: Building a Safer Health System, the IOM estimates that 44,000 to 98,000 Americans die each year not from the medical conditions they checked in with, but from preventable medical errors.

A medical error, under the report's definition, could mean a health-care provider chose an inappropriate method of care, such as giving a patient a certain asthma drug without knowing that he or she was allergic to it. Or it could mean the health provider chose the right course of care but carried it out incorrectly, such as intending to infuse a patient with diluted potassium chloride--a potassium supplement--but inadvertently giving the patient a concentrated, lethal overdose.

The Institute of Medicine (IOM) estimates that fully half of adverse reactions to medicines are the result of medical errors. Other adverse reactions--those that are unexpected and not preventable--are not considered errors. (See "When Is a Medical Product Too Risky?" in the September-October 1999 FDA Consumer.)

The statistics in the IOM report, which were based on two large studies, suggest that medical errors are the eighth leading cause of death among Americans, with error-caused deaths each year in hospitals alone exceeding those from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516).

But the numbers in the report don't tell the whole story, its authors acknowledge. People in the hospital are just a small proportion of those at risk. Doctors' offices, clinics, and outpatient surgical centers treat thousands of patients each day; retail pharmacies fill countless prescriptions; and nursing homes and other institutional settings serve vulnerable patient populations.

Despite the recent focus on the IOM statistics, experts assure that the health system in the United States is safe. But its safety record is a far cry from the enviable record of the similarly complex aviation industry, which is being held up as an example for the medical world. A person would have to fly nonstop for 438 years before expecting to be involved in a deadly airplane crash, based on recent airline accident statistics. That, IOM says, places health-care at least a decade behind aviation in safeguarding consumers' lives and health.

The report is a self-described "call to action" for the health-care system. "Whether a person is sick or just trying to stay healthy, he or she should not have to worry about being harmed by the health system itself," its authors say.

In response to IOM's call, President Clinton has proposed a plan to halve the number of medical errors over five years. "If we do the right things," President Clinton said while announcing the White House plan, "we can dramatically reduce the times when the wrong drug is dispensed, a blood transfusion is mismatched, or a surgery goes awry."

Clinton's plan includes the creation of a new Center for Quality Improvement in Patient Safety, with a $20 million budget, and the installation of patient safety programs to reduce medical errors in each of the 6,000 hospitals participating in Medicare. …

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