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Danger in the O.R.?
August 19, 2003

Medical Mistakes Are an Alarming Trend
By Greg Fisher

Willie King went to the hospital to have his right leg cut off, but woke up to find his left leg missing.

Carl Graham emerged from lung surgery with two massive incisions, instead of just the one he’d expected.

Medical horror stories like these are part of an alarming national trend. A recent Institute of Medicine (IOM) report estimates that between 44,000 and 98,000 people die every year from mistakes made in hospitals. The report concludes that the level of safety in health care is unacceptable. And President Clinton has declared it a national priority.

Becky Cherney is one of three consumer advocates on the Florida Board of Medicine, the state agency that disciplines doctors. She says the figures from the IOM report are the equivalent of a jumbo jet crash per day — 200 people dying every day from medical errors.

The crisis goes undetected, Cherney adds, because the victims die one at a time, in hospitals all around the country, rather than all at once in one giant catastrophe like a plane crash.

Mistakes Lie in the Details

During a typical surgery, doctors and nurses use hundreds of instruments, sponges, needles and towels. And when they lose track of them, it can be devastating for patients.

The Centers for Disease Control estimates that as many as 15,000 people have had foreign objects left inside their bodies after surgery during the last five years.

Although doctors told Paul Young, of Alvarado, Tex., that surgery for his stomach ulcer had gone fine, afterwards he often spent hours at a time hunched over in agony from abdominal pain.  At the grocery store he manages, Young would steal away to hide in the walk-in freezers so his employees would not see him cry.

Even though he had seen dozens of specialists about the pain, it wasn’t until five years later, during a trip to the emergency room, that Young found out what was causing it: A 13-inch surgical instrument, called a retractor, which had been left inside him during the original ulcer surgery.
How could the surgical team have left their tools inside the patient? At the time of Young’s operation, the hospital did not have a system to count instruments, and the team that used the retractor simply forgot to remove it when they were done.

It used to be the operating-room nurse’s job to supervise instrument counts.  But today, not only is there a national shortage of 300,000 nurses, but as a cost-cutting measure, many hospitals use technicians instead.

Like Young, 62-year-old Arlene Meisenburg of Orlando, Fla. learned all about medical mishaps when she had surgery.  Seven months afterward, other doctors discovered that a 30x16-inch surgical towel had been left inside her.

Her family took the case to court and settled with the doctor and the hospital. In addition, the Florida Board of Medicine signed a consent agreement with the doctor, fining him $1,000 and mandating five hours of continuing medical education.

Surgeons Sometimes Miss the Mark

In the last five years, some 50,000 people have filed lawsuits claiming to be victims of the blunder known as “wrong-site surgery.”

Carl Graham, of Tallahassee, Fla., for instance, went in for surgery on one lung, but came out with massive incisions on both sides of his body. Surgery had been mistakenly started for his right lung, even though the CAT-scan clearly showed the tumor was on the left.

Many still remember the case of Willie King, who had the wrong leg amputated at a hospital in Tampa.  King’s surgeon is no stranger to the Florida Board of Medicine.  In all, he has been disciplined for King’s botched surgery, for amputating a woman’s toe without permission, and for putting a central catheter into the wrong patient.

At one meeting last December, the Florida Board of Medicine disciplined six doctors for wrong-site surgery.

Many hospitals now use a system where the patients sign the site to be operated on to make sure there are not any mix-ups, and most also follow the guidelines of the Association of Peri-Operative Resident Nurses to count instruments and sponges during surgery.

MD Records Can Be Difficult to Get

Experts recommend taking an active interest in your own surgery.  Ask your surgeon where you can find information to read about your specific operation.  And find out if your respective state board of medicine has disciplined your doctor in the past or if your doctor has been involved in any malpractice lawsuits.

If you are interested in learning about your doctor’s credentials and malpractice record, you’ll quickly discover that although the information is out there, it’s very difficult to track it down. As things stand now, most of the information available on your doctor depends on your state’s laws.

A growing number of states have “profiling” laws requiring state agencies to compile data on doctors’ education, specialties and hospital affiliations. Several states now include medical malpractice and hospital disciplinary action on their state medical board web sites.

The surest way of finding physicians’ malpractice records is to search the legal record. This kind of search is very time-consuming and can render mixed results, since lawsuits can be filed in different courts and could be overlooked in a search.  Also, even though records of malpractice and disciplinary actions exist at national and state levels, current laws prevent them from being available to the public.   Just last month, however, President Clinton announced his support for mandatory reporting of medical errors through a nationwide reporting system like the one used by airlines to record safety hazards. And the House Commerce Committee is currently reviewing a proposal to open the National Practitioner Data Bank to the public.

Organizations representing doctors and hospitals have argued against making mandatory reporting of medical errors public because they believe it could increase the number of malpractice lawsuits and can provide those that sue with stronger cases. They also say it would engender an environment in which hospitals would be less willing to report their mistakes.

Consumer advocates like Ray McEachern, president of the Association for Responsible Medicine, oppose the current system because they think it is too protective of health-care providers. “There are no vested interests behind the demand for mandatory reporting of hospital mistakes, there is only the public interest,” McEachern says.

Find out more about the House Commerce Committee’s review of the National Practitioner Data Bank: National Practitioner Data Bank Review

If you would like to search for physician profiles and malpractice records, you can use the following resources:

AMA Doctor Finder Provides information about physician training, their specialty and whether they are board certified.
State Medical Boards Online Several states have their physician licensing information online, including information on disciplinary action against a doctor. You can search by doctor’s name.
Physician Profile InformationThis site provides state-by-state information on how to get physician profiles.


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