Posts Tagged ‘ Hospital Error ’

Should Surgeons be Trusted after All-Nighters?

July 25th, 2011. By Hunter West

Say your doctor was on call all night the night before your scheduled 6 a.m. surgery. Would you still want to go under the knife?

It has long been debated that the effects of sleep deprivation can be just as harmful—and just as much an impairment—as that delivered from alcohol, or drugs. Bottom line: when we’re tired, we screw up.

You run off the road while driving, your reflexes are slower. Worse, when you try to counter the fog in your brain and the yawn on your face with copious amounts of caffeine or other stimulants, you have reflexes unsupported by studied thought—a pure reactive state, with little depth or substance from a sleep-deprived brain straining to carry on with the aid of chemicals in the place of rest.

So why is there not more dialog on this with regard to the medical profession and medical errors?

Recently, the Canadian Medical Association Journal (CMAJ) published an editorial on the sleepy doctor syndrome. Not only did the CMAJ target the problem at the doctor and hospital level, it also called upon legislators to develop national standards in the regulated health care industry to protect patients from sleepy docs.

There is valid reason for this concern.

Beyond the temptation for some doctors to wear sleep deprivation as a badge of honor—or hospitals having to make do with fewer staff amidst the realities of a health care system under siege and shrinking health care dollars—are studies that paint an alarming picture of both where we are, and where we’re headed.

According to a story in the Montreal Gazette (5/25/11), studies have shown a near doubling in the rate of complications when surgeons operate with fewer than six hours of sleep—usually following a night on call.

Those complications have been found to include injuries to organs (a slip of the scalpel), and massive hemorrhaging. Such events can put a patient’s life in immediate danger, or affect their health over the long term.

The doctor, in contrast, goes home to a pillow and beyond feeling regret for the error, is not required to live with the consequences of that error for a lifetime. Unless, of course, a medical malpractice lawsuit is filed.

Mistakes happen, and to err is human nature. But in publishing its editorial, the CMAJ suggested that an already serious problem is about to get worse given the increasing complexities of the health care field. “Unprecedented” demands are placed on a doctor’s physical and cognitive health, as a result.

“Those of us who remain overconfident that we can continue to perform our duties properly with inadequate sleep should imagine the reaction if we were made to seek informed consent from each of our patients to accept treatment under these conditions,” state the authors, adding that working while sleep deprived is neither “normal nor acceptable.”

The authors also point out that—in Canada at least—limits on how long a resident, intern or medical student can go without sleep are not extended to practicing doctors, who often work without supervision and are often older and thus even more susceptible to the effects of lack of sleep.

Such situations are ripe for malpractice lawsuits—and doctors, together with the hospitals that employ them, need to be cognizant of that fact. Errors are unavoidable—but they can me managed and mitigated.

There are already efforts underway in other areas of the health care system. Increasing the use of checks and balances—akin to the checklist in the airline cockpit—helps ensure that the surgeon is operating on the correct patient and is performing the correct procedure in, or on the requisite are of the patient’s body.

Similar-looking labels on drug containers are being changed to avoid confusion in the pharmacy. Lawsuits, together with media scrutiny and public outrage, have helped to motivate the powers that be into action.

What of sleepy docs? Will a spate of lawsuits prompt the health care industry to action beyond mere debate? Lawsuits might be business for the lawyers, and monetary settlements necessary for the affected plaintiffs. But most would prefer to have been spared amputation of the wrong leg, or a scalpel nick that brought on a lifetime of pain or complication, all because the doctor yawned at the wrong time, or wasn’t in total control of his movements just because he was so bloody tired.

Maybe you can collect garbage on a few hours sleep. But I, for one, don’t want anyone going near me with a knife if they might be tired and sleep deprived.

Don’t be a hero. Sign out, go to bed, and let someone else do it. And somebody, somewhere needs to come up with a system that guarantees that.

Tags: Canadian Medical Association Journal, CMAJ, doctor error, Hospital Error, medical malpractice, tired doctors
Posted in Drugs/Medical, Personal Injury | 1 Comment »

Post-Op News You Don’t Want: Oops! Hospital Errors Still Happening

November 17th, 2010. By LucyC

Stories about hospital screw-ups and medical malpractice suits—you know, mistakes that nearly cost someone his life—are typically good coffee break fodder and undoubtedly the stuff of urban legend. However, I came across this news story today and it was a bit of a wake-up call. According to a report by United Press International, 12 California hospitals were recently fined between $25,000 and $75,000 each “for medical errors that caused, or were likely to cause, injury or death.” Twelve hospitals. 

One of the facilities that screwed up and got caught, according to officials with California’s Department of Public Health, is Southwest Healthcare System in Murrieta, CA. They were fined $25,000 for leaving a surgical instrument—”a metal device roughly 10 inches long and 2 inches wide used to hold tissue during surgery—inside a woman who had a baby in 2008.” I’m going to assume that that means the surgical team left the device inside the woman following her Caesarean section. Nobody noticed until the woman complained of pain. So she underwent exploratory surgery and the instrument was found. Apparently the report that was written about the incident listed one of the possible reasons for the mistake as unfamiliarity between the two doctors who were operating—meaning the docs didn’t know each other. Isn’t that why procedures were developed?

Again, to cite the UPI story, this particular facility has been fined by the state seven times. And, Southwest Healthcare System is not alone in its stunning lack of adherence to procedure: California Pacific Medical Center, Pacific Campus Hospital, San Francisco, was fined $50,000 and $75,000 for negligence involving two different patients; Citrus Valley Medical Center in Covina, Read the rest of this entry »

Tags: Hospital Error, medical malpractice, Veterans Hospital, veterans medical malpractice
Posted in Drugs/Medical | No Comments »

James Woods and Hospital Settle Wrongful Death Lawsuit

December 3rd, 2009. By AbiK

After blogging about HAI’s (Healthcare Associated Infections) recently, and recalling some of the recent reports on MRSA, I was thinking about the James Woods trial–the one where his brother, Michael Woods, had gone to the emergency room at Kent Hospital in Rhode Island back in 2006 with a sore throat and vomiting; he wound up dying after a heart attack. The wrongful death lawsuit centered around James Woods’ charge that the hospital didn’t do enough to save his brother’s life.

Well, they’ve settled the lawsuit. Yes, the Woods family did get an “undisclosed” amount of money, but according to the Associated Press, they also got a belated apology from the hospital and an agreement from the hospital that a new institute, the Michael J. Woods Institute at Kent Hospital, will be created to to find ways to reduce human errors at hospitals.

According to AP, “The hospital agreed to invest $1.25 million over the next five years in the institute, which will look at how to reduce the risk of errors based on how humans actually do things, also known as human factors research. Its leadership will include a representative of Michael Woods’ family, as well as experts from inside and outside of the hospital.”

Tags: Hospital Error, James Woods, Wrongful Death
Posted in Drugs/Medical | 3 Comments »