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12/Sep/2016
The Frightening Reality of Medical Error

Medical error is an umbrella term that covers all manner of human failure: diagnostic mistakes, poor judgment, a collapse in communication, insufficient skill, equipment malfunction, preventable adverse effects, and a departure from the standard process of care.[1] Here’s a primer on how often medical errors happen in hospitals, why they are so rarely reported, and how legal counsel can help.

The statistics

Last year, a video on medical errors was prepared by University Health Network (UHN) — a healthcare and medical research organization that includes Toronto General, Toronto Western, Toronto Rehab, and Princess Margaret hospitals — and presented at its annual general meeting. The data was bleak. In 2013, inappropriate prescriptions written to older patients cost the Canadian health care system $419 million.[2] In 2014, some 200,000 patients across Canada acquired an infection that they did not have on arrival at the hospital.[3] According to the Canadian Institute for Health Information, items are left behind in patients roughly 7.5 times for every 100,000 surgeries in Ontario alone.[4] The cost to Canadians for preventable adverse effects in acute care amounts to over $396 million every year.

Public perception vastly underestimates the prevalence of medical errors: in one study cited by UHN, people guessed there were about 500 preventable deaths that occurred in a hospital each year. The reality is that in 2014, medical errors were responsible for the deaths of as many as 30,277 Canadians — more than stroke, diabetes, Alzheimer’s, and kidney disease combined. That means that every 17 minutes, a patient dies in Canada from a preventable death while in medical care.[5]

But these numbers don’t tell a complete story. Cross-checking American hospital admission rates with medical death rate data, a pair of patient-safety researchers from Johns Hopkins University estimated that there were 251,454 preventable deaths in the United States in 2013. Based on that assessment, medical error has now become the third leading cause of death in America, behind heart disease and cancer.[6] However, given that these outdated reporting methods do not distinguish between how often patients die from issues of care, rather than from complications of disease, the researchers emphasized that this number is likely a low estimate.[7] Notwithstanding the difference in American population size and medical practices, the same trends exist in Canada.

The silence

On a commercial airline, as in a hospital, human error can have fatal consequences. But North American aviation industries have been radically transparent about their mistakes. U.S. federal law mandates that airlines report all crashes to the National Transportation Safety Board for investigation,[8] while Canada’s Transportation Safety Board provides public information surrounding not just crashes but minor errors.[9] Procedures are carefully scrutinized so that events don’t repeat themselves. As a result, on Western-made jets, a single accident occurs for every 2.4 million commercial flights. In Canada, on the other hand, medical errors add up to the equivalent of two 747 planes crashing every week. And since no national regulator or database exists, no one needs to be notified.[10]

A 2015 National Post investigation into medical errors chalked up the silence to a health-care system plagued by traditional hierarchy, anxiety over legal action, and an emphasis on case-by-case punishment rather than examining — and learning from — the bigger picture. Whereas the aviation industry penalizes those who fail to report safety concerns, professionals within the medical community remain cautious about whistle-blowing. Nurses fear reprisals from physicians; physicians fear the loss of jobs; hospitals fear bad exposure and the loss of patient confidence.[11]

The need for change

The Johns Hopkins researchers stress that medical errors don’t stem from innately malicious or mediocre doctors. Instead, these errors tend to be a result of systemic problems, hierarchical hospital structures, poor safety nets, and unnecessary discrepancies in how physicians deliver care.[12] When Johns Hopkins introduced a mandatory, five-step checklist for inserting central-line catheters, for example, preventable infections fell by 70 percent in six months.[13] When team training programs — which emphasize coordination and communication among health care providers — are introduced into hospitals, the instances of medical errors fall by 19 percent.[14] Transparent reporting of medical errors would also help speed safety efforts and identify those systemic failures so that they may be resolved.

The need for legal counsel

It is well settled in law that a medical error is not necessarily negligent. However, research has shown that there is a systemic problem of secrecy surrounding medical errors in Ontario and in Canada. While we hope to see improvements and greater transparency in our healthcare system, it is always beneficial to consult experienced legal counsel who can guide you through the daunting task of determining whether you have a legitimate claim against a health care provider or hospital.

Medical errors can have serious consequences for patients, whose quality of life can suffer greatly as a result of a doctor’s malpractice. Many victims find they cannot continue to work, or incur considerable expenses for rehabilitation and additional medical care. Bogoroch & Associates LLP prides ourselves on serving as tireless advocates for our clients. For further information, please contact Richard M. Bogoroch rbogoroch@bogoroch.com or Heidi Brown at hbrown@bogoroch.com.

 


[1] http://www.bmj.com/content/353/bmj.i2139

[2] http://cmajopen.ca/content/4/2/E346.full

[3]http://www.uhn.ca/corporate/News/Pages/Dr_Peter_Pisters_looks_ahead_with_new_vision_for_UHN.aspx

[4] http://www.citynews.ca/2016/05/09/canada-falling-short-in-tracking-doctor-error-deaths-and-surgeries/

[5]http://www.uhn.ca/corporate/News/Pages/Dr_Peter_Pisters_looks_ahead_with_new_vision_for_UHN.aspx

[6] http://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

[7] http://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors

[8] http://www.vox.com/2016/5/3/11579974/medical-errors-death-harm

[9] http://news.nationalpost.com/health/inside-canadas-secret-world-of-medical-errors-there-is-a-lot-of-lying-theres-a-lot-of-cover-up?__lsa=84c5-a6a7

[10] http://www.theglobeandmail.com/life/health-and-fitness/health/toronto-hospitals-embark-on-safety-initiative-to-prevent-medical-error-deaths/article30610569/

[11] http://news.nationalpost.com/health/inside-canadas-secret-world-of-medical-errors-there-is-a-lot-of-lying-theres-a-lot-of-cover-up?__lsa=84c5-a6a7

[12] http://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death

[13] http://content.healthaffairs.org/content/30/4/628.full

[14] http://www.futurity.org/health-care-team-training-1204252/

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