Hospital Hazards

The New England Journal of Medicine  published this Thanksgiving week, a report showing the patient safety in hospitals has not improved over the years 2002-2007.  This despite the fact the study was conducted in North Carolina whose hospitals, compare favorably with other states and where the hospitals have been more involved in programs to improve patient safety. Harm to patients was common and the number of incidents did not decrease over time. The most common problems were complications from procedures or drugs and hospital-acquired infections.

Among the preventable problems that Dr. Landrigan’s, a Harvard Professor and his team identified, were severe bleeding during an operation, serious breathing trouble caused by a procedure that was performed incorrectly, a fall causing dislocation or hip fracture,  and vaginal injuries caused by a vacuum device used in some deliveries.

As also described in the New York Times on Nov. 25 this is “one of the most rigorous  efforts to collect data about patient safety since a landmark report in 1999.”  That widely quoted report by the Institute of Medicine, an independent group that advises the government on health matters, found that medical mistakes caused as many as 98,000 deaths and more than one million injuries a year in the United Stat

The Harvard researchers found a high rate of problems. About 18% of patients were harmed by medical care, some more than once, and 63%  of the injuries were judged to be preventable.  In 2.4%  of cases the problems caused or contributed to the patient’s death.

A recent government report found similar shocking findings.  In October 2008, 13.5 percent of Medicare beneficiaries — 134,000 patients — experienced “adverse events” during hospital stays. In 7% of these patients   medical mistakes contributed to their deaths. That report, was issued this month (Nov. 2010) by Department of Health and Human Services.

Dr. Landrigan’s study reviewed the records of 2,341 patients admitted to 10 hospitals — not named-in both urban and rural areas and involving large and small medical centers. The researchers used a list of  red flags to pinpoint possible problems.  They included drugs used only to reverse an overdose, the presence of bedsores or the patient’s readmission to the hospital within 30 days.

The researchers found 588 instances in which a patient was harmed by medical care, or 25  injuries per 100 admissions!

This is most likely the tip of the iceberg of medical injuries resulting from hospital “care.” How many injuries and deaths due to mistakes, misadventures, medical errors, and other causes occur outside of hospitals? Will we ever know?

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