Medical Errors Quotes

new report has discovered that medical errors are the third-leading cause of death among Americans after heart attacks and cancer. Sleeplessness undoubtedly plays a role in those lives lost.

making some types of errors is the most rational thing to do, when the errors are of little cost, as they lead to discoveries. For instance, most medical “discoveries”are accidental to something else. An error-free world would have no penicillin, no chemotherapy…almost no drugs, and most probably no humans. This is why I have been against the state dictating to us what we “should”be doing: only evolution knows if the “wrong”thing is really wrong, provided there is skin in the game to allow for selection.

Anxiety is not a sign of sickness, a weakness of the mind, or an error for which we should always seek a medical solution. It is mostly a hugely reasonable and sensitive response to the genuine strangeness, terror, uncertainty, and riskiness of existence.

For, medicine being a compendium of the successive and contradictory mistakes of medical practitioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognized in a few years’ time. So that to believe in medicine would be the height of folly, if not to believe in it were not greater folly still, for from this mass of errors there have emerged in the course of time many truths.

Much of the discussion in this book is about biases of intuition. However, the focus on error does not denigrate human intelligence, any more than the attention to diseases in medical texts denies good health.

...never [enter] into dispute or argument with another. I never saw an instance of one of two disputants convincing the other by argument. I have seen many, on their getting warm, becoming rude, & shooting one another. ... When I hear another express an opinion which is not mine, I say to myself, he has a right to his opinion, as I to mine; why should I question it? His error does me no injury, and shall I become a Don Quixote, to bring all men by force of argument to one opinion? ... There are two classes of disputants most frequently to be met with among us. The first is of young students, just entered the threshold of science, with a first view of its outlines, not yet filled up with the details & modifications which a further progress would bring to their knoledge. The other consists of the ill-tempered & rude men in society, who have taken up a passion for politics. ... Consider yourself, when with them, as among the patients of Bedlam, needing medical more than moral counsel. Be a listener only, keep within yourself, and endeavor to establish with yourself the habit of silence, especially on politics. In the fevered state of our country, no good can ever result from any attempt to set one of these fiery zealots to rights, either in fact or principle. They are determined as to the facts they will believe, and the opinions on which they will act. Get by them, therefore, as you would by an angry bull; it is not for a man of sense to dispute the road with such an animal.

The important question isn't how to keep bad physicians from harming patient; it's how to keep good physicians from harming patients. Medical malpractice suits are a remarkably ineffective remedy. (In reference to a Harvard Medical Practice Study)... fewer than 2 percent of the patients who had received substandard care ever filed suit. Conversely, only a small minority among patients who did sue had in fact been victims of negligent care. And a patient's likelihood of winning a suit depended primarily on how poor his or her outcome was, regardless of whether that outcome was caused by disease or unavoidable risks of care. The deeper problem with medical malpractice is that by demonizing errors they prevent doctors from acknowledging & discussing them publicly. The tort system makes adversaries of patient & physician, and pushes each other to offer a heavily slanted version of events.

Now, we shall be able to judge the extent of the spiritual undernourishment if we look at all these movements from another angle: not as errors but rather as attempts to find healing. I use this comparison: For a long time medical men combated fever as if it itself constituted the illness. Medicine today inclines rather to respect it, not only as a symptom of the disease but of the struggle of the organism against the disease. True, it is this struggle which makes it ill, and yet this very struggle is also the proof of its vitality and is the necessary way to healing.

Decisions which affect the individual's health and life should not be forced upon him by self-appointed groups of experts who are not even in a position to take responsibility for their errors.

Medical errors in hospitals are estimated to cause more than 400,000 deaths per year in the U.S. alone—making it the third leading cause of death after heart disease and cancer—with another 4–6 million cases of serious harm.34

Rather than being fearful of not detecting disease, both patients and doctors should fear healthcare. The best way to avoid medical errors is to avoid medical care. The default should be: I am well. The way to stay that way is to keep making good choices - not to have my doctor look for problems.

in counties containing teaching hospitals, fatal medication errors spiked by 10% in July

It is almost impossible for contemporaries to judge the true value of discoveries, or to give the proper position to the men of their own time who make these discoveries. The Surgeon-General of the Public Health Service expected the greatest results to flow from his commission of medical officers, but the conclusions of the Board turned out to be all wrong, while he did not notice the report from his own subordinate, Dr. H. R. Carter, which turned out to be pure gold and was one of the great steps in establishing the true method of the transmission of Yellow Fever.

Operations like that lap chole have taught me how easily error can occur, but they’ve also showed me something else: effort does matter; diligence and attention to the minutest details can save you.” .

Participatory Medicine is a model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care on all issues related to an individual’s health. Participatory medicine is an ethical approach to care that also holds promise to improve outcomes, reduce medical errors, increase patient satisfaction and improve the cost of care.

For, medicine being a compendium of the successive and contradictory mistakes of doctors, even when we call in the best of them the chances are that we may be staking our hopes on some medical theory that will be proved false in a few years. So that to believe in medicine would be utter madness, were it not still a greater madness not to believe in it, for from this accumulation of errors a few valid theories have emerged in the long run.

Nonetheless, Donahue was convinced that the rest of the medical evidence, plus the direction of the fibers around the holes in the President's shirt, reasonably supported the contention that Kennedy and Connally were hit by the same bullet. But could

For, medicine being a compendium of the successive and contradictory mistakes of medical practioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognised in a few years’ time

Carolyn and I struggled with how or if to forgive while we dealt with the impact of the clinic's actions. Kevin Anderson helped us by introducing the idea of intolerant forgiveness: the ability to forgive the person who committed the error, but not the actual mistake.

For, medicine being a compendium of the successive and contradictory mistakes of medical practitioners, when we summon the wisest of them to our aid the chances are that we may be relying on a scientific truth the error of which will be recognised in a few years’ time.

Hospitals are supposed to help heal the sick. How, then, do we explain the thousands of Americans harmed in hospitals every year when patients are given the wrong medication? In addition to the devastating human toll, these preventable errors cost an estimated $3.5 billion in extra medical expenses.

To change the culture leaders must make it clear that if a team member does make a medication error, it’s a process problem, not a people problem. Our job as managers and leaders is to redesign the process that delivered the defect. The culture changes when the leaders focus on the process and quit blaming the people.

We don't live in a world of perfect non-violent beauty. If we don't do the trials on animal specimens first, would you rather give yourself or a relative of yours up for experimentation! Some may say, why don't we avoid experimentation on live specimens all together - to them I say, modern medicine is not magic to work without errors - and hard and cruel as it may sound, a live animal specimen is expendable, but not a live human being. You may say, that's not fair - and indeed, it is in no way fair, but that's the reality. The only fairer alternative is to let humans suffer and die from diseases, like they used to, until about a few centuries ago.

the witch was an empiricist: she relied on her senses rather than on faith or doctrine, she believed in trial and error, cause and effect. Her attitude was not religiously passive, but actively inquiring. She trusted her ability to find ways to deal with disease, pregnancy, and childbirth—whether through medications or charms.

Although they will miss his presence if he dies, his condition is too burdensome to require his continued presence. In such circumstances, what is selfish is the insistence that the prospective suicide remain alive, not that he seek his own demise. The argument about selfishness can backfire in another way. Just as it is sometimes the case that those who kill themselves have accorded insufficient weight to the interests of others, so it is sometimes the case that those who do not kill themselves make this error. Consistent with what I have already said, I do not think that the interests of others are decisive. Nevertheless, there are situations in which a person's interest in continued life is negligible, because he will die soon anyway, and the quality of his life is appalling. If seeing out his days, rather than taking his own life earlier, would spell financial ruin for his family (because of the costs of his medical care), then it may well be unduly selfish not to take one's own life.

What worries me is the acceptance of the importance of feelings without any effort to understand their complex biological and sociocultural machinery. The best example of this attitude can be found in the attempt to explain bruised feelings or irrational behavior by appealing to surface social causes or the action of neurotransmitters, two explanations that pervade the social discourse as presented in the visual and printed media; and in the attempt to correct personal and social problems with medical and nonmedical drugs. It is precisely this lack of understanding of the nature of feelings and reason (one of the hallmarks of the "culture of complaint") that is cause for alarm.

Psychologists often make a distinction between mistakes where we already know the right answer and mistakes where we don’t. A medication error, for example, is a mistake of the former kind: the nurse knew she should have administered Medicine A but inadvertently administered Medicine B, perhaps because of confusing labeling combined with pressure of time. But sometimes mistakes are consciously made as part of a process of discovery. Drug companies test lots of different combinations of chemicals to see which have efficacy and which don’t. Nobody knows in advance which will work and which won’t, but this is precisely why they test extensively, and fail often. It is integral to progress.

Journal of the American Medical Association (JAMA), included a recent article by Barbara Starfield, M.D., stating that physician error, medication error and adverse events from drugs or surgery kill 225,400 people per year (Chart 1.5).11 That makes our health care system the third leading cause of death in the United States, behind only cancer and heart disease

In all cases, life had already ceased for the patient. In fact, life had ceased before the code started. That was the time when the patient had stopped breathing or the heart had stopped beating. That was when the patient had really died. Yet we officially record the time of death as the moment when we adjourn our battle, not the moment the cells have adjourned theirs.

In a strange way, death is actually one of the steps of the code. It isn't listed in the algorithm, of course, but it's there. The first step. Everyone knows it, but no one will say it. Even though the patient has already died from the devastation of disease, the code presses on until someone "calls it." Then, and only then, can death be acknowledged. It is a wrenching combination of human grief and quotidian bureaucracy.

For, medicine being a compendium of the successive and contradictory mistakes of medical practioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognised in a few years’ time. So that to believe in medicine would be the height of folly, if not to believe in it were not greater folly still, for from this mass of errors there have emerged in the course of time many truths.

In 2013 a study published in the Journal of Patient Safety8 put the number of premature deaths associated with preventable harm at more than 400,000 per year. (Categories of avoidable harm include misdiagnosis, dispensing the wrong drugs, injuring the patient during surgery, operating on the wrong part of the body, improper transfusions, falls, burns, pressure ulcers, and postoperative complications.) Testifying to a Senate hearing in the summer of 2014, Peter J. Pronovost, MD, professor at the Johns Hopkins University School of Medicine and one of the most respected clinicians in the world, pointed out that this is the equivalent of two jumbo jets falling out of the sky every twenty-four hours. “What these numbers say is that every day, a 747, two of them are crashing. Every two months, 9/11 is occurring,” he said. “We would not tolerate that degree of preventable harm in any other forum.”9 These figures place preventable medical error in hospitals as the third biggest killer in the United States—behind only heart disease and cancer.

It seems obvious that throughout history, as one of the few professions open to women, midwifery must have attracted women of unusual intelligence, competence, and self-respect§. While acknowledging that many remedies used by the witches were “purely magical” and worked, if at all, by suggestion, Ehrenreich and English point out an important distinction between the witch-healer and the medical man of the late Middle Ages: . . . the witch was an empiricist; She relied on her senses rather than on faith or doctrine, she believed in trial and error, cause and effect. Her attitude was not religiously passive, but actively inquiring. She trusted her ability to find ways to deal with disease, pregnancy and childbirth—whether through medication or charms. In short, her magic was the science of her time. By contrast: There was nothing in late mediaeval medical training that conflicted with church doctrine, and little that we would recognize as “science”. Medical students . . . spent years studying Plato, Aristotle and Christian theology. . . . While a student, a doctor rarely saw any patients at all, and no experimentation of any kind was taught. . . . Confronted with a sick person, the university-trained physician had little to go on but superstition. . . . Such was the state of medical “science” at the time when witch-healers were persecuted for being practitioners of “magic”.15 Since asepsis and the transmission of disease through bacteria and unwashed hands was utterly unknown until the latter part of the nineteenth century, dirt was a presence in any medical situation—real dirt, not the misogynistic dirt associated by males with the female body. The midwife, who attended only women in labor, carried fewer disease bacteria with her than the physician.

No doubt there are other inferior clinics out there. Poor care, overpricing, and rude staffers can be found in every medical field. But you don’t find people using examples of it to inveigh against an entire specialty—railing against the greed of orthopedic surgeons (average 2012 salary, $315,000) or calling for surprise inspections of dentists because every year a few people die from preventable errors during dental procedures.8 Only in abortion care do the few bad providers taint all the others—and taint them so much that opponents can pass laws that would virtually shut down the entire field in the name of patient safety. No

While all of us dread being blamed, we all would wish to be more responsible—that is, to have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us. There is no true responsibility without awareness. One of the weaknesses of the Western medical approach is that we have made the physician the only authority, with the patient too often a mere recipient of the treatment or cure. People are deprived of the opportunity to become truly responsible. None of us are to be blamed if we succumb to illness and death. Any one of us might succumb at any time, but the more we can learn about ourselves, the less prone we are to become passive victims. Mind and body links have to be seen not only for our understanding of illness but also for our understanding of health. Dr. Robert Maunder, on the psychiatric faculty of the University of Toronto, has written about the mindbody interface in disease. “Trying to identify and to answer the question of stress,” he said to me in an interview, “is more likely to lead to health than ignoring the question.” In healing, every bit of information, every piece of the truth, may be crucial. If a link exists between emotions and physiology, not to inform people of it will deprive them of a powerful tool. And here we confront the inadequacy of language. Even to speak about links between mind and body is to imply that two discrete entities are somehow connected to each other. Yet in life there is no such separation; there is no body that is not mind, no mind that is not body. The word mindbody has been suggested to convey the real state of things. Not even in the West is mind-body thinking completely new. In one of Plato’s dialogues, Socrates quotes a Thracian doctor’s criticism of his Greek colleagues: “This is the reason why the cure of so many diseases is unknown to the physicians of Hellas; they are ignorant of the whole. For this is the great error of our day in the treatment of the human body, that physicians separate the mind from the body.” You cannot split mind from body, said Socrates—nearly two and a half millennia before the advent of psychoneuroimmunoendocrinology!

It was only when professionals believed that reports on errors and near misses would be treated as learning opportunities rather than a pretext to blame that this crucial information started to flow. Managers were initially worried that reducing the penalties for error would lead to an increase in the number of errors. In fact, the opposite happened. Insurance claims fell by a dramatic 74 percent. Similar results have been found elsewhere. Claims and lawsuits made against the University of Michigan Health System, for example, dropped from 262 in August 2001 to 83 following the introduction of an open disclosure policy in 2007. The number of lawsuits against the University of Illinois Medical Center fell by half in two years after creating a system of open reporting.

The mistake made by the more refined among them [among the modern historians of morality] is that they uncover and criticize the perhaps foolish opinions of a people about morality, or of humanity about all human morality—opinions about its origin, religious sanction, the superstition of free will, and things of that sort—and then suppose that they have criticized the morality itself. But the value of a command, “thou shalt” is still fundamentally different from and independent of such opinions about it and the weeds of error that may have overgrown it—just as certainly as the value of a medication for a sick person is completely independent of whether he thinks about medicine scientifically or the way old women do. Even if a morality has grown out of an error, the realization of this fact would not as much as touch the problem of its value.

Take, for example, the following sentence: “I prefer to eat with a fork and a camel.” Your brain has just generated an N400 wave, an error signal evoked by a word or an image which is incompatible with the preceding context.11 As its name suggests, this is a negative response that occurs at about four hundred milliseconds after the anomaly and arises from neuronal populations of the left temporal cortex that are sensitive to word meaning. On the other hand, Broca’s area in the inferior prefrontal cortex reacts to errors of syntax, when the brain predicts a certain category of word and receives another,12 as in the following sentence: “Don’t hesitate to take your whenever medication you feel sick.” This time, just after the unexpected word “whenever,” the areas of your brain that specialize in syntax emitted a negative wave immediately followed by a P600 wave—a positive peak that occurs around six hundred milliseconds. This response indicates that your brain detected a grammar error and is trying to repair it.

Yet, it was precisely our failure to differentiate between work and politics, between reality and illusion; it was precisely our mistake of conceiving of politics as a rational human activity comparable to the sowing of seeds or the construction of buildings that was responsible for the fact that a painter who failed to make the grade was able to plunge the whole world into misery. And I have stressed again and again that the main purpose of this book—which, after all, was not written merely for the fun of it—was to demonstrate these catastrophic errors in human thinking and to eliminate irrationalism from politics. It is an essential part of our social tragedy that the farmer, the industrial worker, the physician, etc., do not influence social existence solely through their social activities, but also and even predominantly through their political ideologies. For political activity hinders objective and professional activity; it splits every profession into inimical ideologic groups; creates a dichotomy in the body of industrial workers; limits the activity of the medical profession and harms the patients. In short, it is precisely political activity that prevents the realization of that which it pretends to fight for: peace, work, security, international cooperation, free objective speech, freedom of religion, etc.

When you are visited by chaos and swallowed up; when nature curses you or someone you love with illness; or when tyranny rends asunder something of value that you have built, it is salutary to know the rest of the story. All of that misfortune is only the bitter half of the tale of existence, without taking note of the heroic element of redemption or the nobility of the human spirit requiring a certain responsibility to shoulder. We ignore that addition to the story at our peril, because life is so difficult that losing sight of the heroic part of existence could cost us everything. We do not want that to happen. We need instead to take heart, and to take spirit, and to look at things carefully and properly, and to live the way that we could live. You have sources of strength upon which you can draw, and even though they may not work well, they may be enough. You have what you can learn if you can accept your error. You have medications and hospitals, as well as physicians and nurses who genuinely and bravely care to lift you up and help you through every day. And then you have your own character and courage, and if those have been beat to a bloody pulp and you are ready to throw in the towel, you have the character and courage of those for whom you care and who care for you. And maybe, just maybe, with all that, you can get through.

We know nothing about how those earliest known surface glazes themselves were developed. Nevertheless, we can infer the methods of prehistoric invention by watching technologically “primitive” people today, such as the New Guineans with whom I work. I already mentioned their knowledge of hundreds of local plant and animal species and each species’ edibility, medical value, and other uses. New Guineans told me similarly about dozens of rock types in their environment and each type’s hardness, color, behavior when struck or flaked, and uses. All of that knowledge is acquired by observation and by trial and error. I see that process of “invention” going on whenever I take New Guineans to work with me in an area away from their homes. They constantly pick up unfamiliar things in the forest, tinker with them, and occasionally find them useful enough to bring home. I see the same process when I am abandoning a campsite, and local people come to scavenge what is left. They play with my discarded objects and try to figure out whether they might be useful in New Guinea society. Discarded tin cans are easy: they end up reused as containers. Other objects are tested for purposes very different from the one for which they were manufactured. How would that yellow number 2 pencil look as an ornament, inserted through a pierced ear-lobe or nasal septum? Is that piece of broken glass sufficiently sharp and strong to be useful as a knife? Eureka!

What the research shows is that the charge master and commercial insurance company prices for the same test or treatment will also vary substantially even at neighboring medical facilities where, presumably, basic input costs such as rent and wages do not vary substantially. Colonoscopies in New York City can vary fourfold—between $2,025 and $8,700—depending on the hospital. This variation in price is very hard to justify. Typically, neither patients nor physicians have access to the price, so they cannot shop around for lower prices. Imagine you were shopping for a new shirt but there was no price tag and you could not know until weeks after you bought it whether the shirt cost $25 or $200. This would make shopping a crazy experience.

One study concluded that there were 1.7 errors per patient per day in America's ICUs. Of these errors, 29 percent could have caused clinically significant harm or death. Given that the average ICU length of stay is three days, this research suggests that nearly all patients hospitalized in the ICU sustain a potentially life-threatening mistake at some point during their stay.

The taxonomy of medical error is vast, colorful, and at times confusing. There are slips, lapses, harmless hits, and near misses; errors of omission and of commission; operator errors, system errors, accidents, complications, and bad outcomes.

physician error, medication error and adverse events from drugs or surgery kill 225,400 people per year (Chart 1.5).11 That makes our health care system the third leading cause of death in the United States, behind only cancer and heart disease (Chart 1.4

About the same number of people die each year from medical errors as from automobile accidents. Heart disease and cancer kill the most people in the United States, more than 500,000 each year. But stroke and lung diseases are each responsible for about 100,000 deaths each year — and scandalously, so are medical errors. Medical errors are notoriously difficult to track, given our litigious society, so we really do not know how many deaths that statisticians attribute to cancer or heart disease were also related to medical errors. But given the high likelihood that errors are implicated in some of these deaths, it is possible that medical errors could be the third leading cause of death in the United States.

But though I admire their intentions and ambitions, I contend that they have missed the big picture: the underlying insurance-based structure of our health care system drives excess treatment, cost inflation, and medical errors. It is this structure that needs to be changed.

Nearly all diseases that have baffled the medical profession may be traced to some deficiency in our diet, and it may be truthfully said, that at least ninety per cent of human ailments are traceable to inadequate and faulty nutrition. Yet in no part of study and observation has medical need been more insufficiently met than in that of rational dietetics, both in relation to the maintenance of health, and in the treatment and prevention of disease. By far the most detrimental effect of faulty nutrition is the result of habitual errors of one kind or another, which are not sufficiently grave to command immediate attention. For instance, we may abuse our pancreas and kidneys for years, without the feeling of pain, until these organs are finally injured beyond repair. It is the gradual operation of more or less constant, but unperceived causes, rather than of accidental exposures to abnormal conditions, which in most cases are responsible for undermining the health of the individual

physician error, medication error and adverse events from drugs or surgery kill 225,400 people per year (Chart 1.5).11 That makes our health care system the third leading cause of death in the United States, behind only cancer and heart disease (Chart 1.4).

it makes medical error the third leading cause of death in the United States today, just behind heart disease and cancer.

The death toll from health care screwups adds up to at least 500,000 Americans annually. That is the equivalent of more than three jumbo jets crashing every day of the year (or over 1,000 jets annually). Because these individuals are dying at home, in hospitals, or in nursing homes, no one is counting the bodies. There is no outrage, no plan to change a system that allows too many to die unnecessarily. The medical profession seems largely immune to the consequences of its errors.

The problem is not a small group of crazy, homicidal, incompetent doctors going around causing havoc. Medical errors follow a normal bell-shaped distribution.14 They occur most often not when clinicians get bored or lazy or malign, but when they are going about their business with the diligence and concern you would expect from the medical profession.

The cost of errors is enormous: o Medical errors in the US incur an estimated economic value of almost USD 1 trillion78 – and 86% of those mistakes are administrative.79 o 80% of US medical billings contain at least minor mistakes – creating unnecessary annual healthcare spending of $68 billion.80

I call time-outs like these “vigilance breaks”—brief pauses before high-stakes encounters to review instructions and guard against error. Vigilance breaks have gone a long way in preventing the University of Michigan Medical Center from transmogrifying into the Hospital of Doom during the afternoon trough. Tremper says that in the time since he implemented these breaks, the quality of care has risen, complications have declined, and both doctors and patients are more at ease.

Medical errors—third leading cause of death in the U.S.—signifies a moral, professional, and public health dilemma.

An organization's financial statement is their ethical statement. This is because what an organization spends their money on defines what's important to them.

Or take the health category. Adding is on the left, removing to the right. Removing medication, or some other unnatural stressor—say, gluten, fructose, tranquilizers, nail polish, or some such substance—by trial and error is more robust than adding medication, with unknown side effects, unknown in spite of the statements about “evidence” and shmevidence.

Every time a patient receives a medication in the hospital, there’s a 20%–25% probability that it involves at least one clinical error—the drug may be given at the wrong time or at the wrong injection rate, or maybe it’s the wrong formulation.

Every time you give a patient a treatment, you are experimenting to see what will happen. As every patient is unique, medical work is essentially experimental, uncertain, and, consequently, prone to error. And no treatment is absolutely necessary.

In Rome, the person in charge of equipollenza, or training equivalency, was located at the Foreign Ministry. I got into that mass of marble by depositing my passport at the front desk, and was escorted through dimly-lit halls wearing a temporary ID badge on my lapel and clutching my little pile of documents. The diminutive official took a glance at my grimy Xeroxes and harrumphed a little laugh through his moustache. The colleague at the New York Consulate had unfortunately gotten several things wrong, he said. First a procedural error: the “authenticating” squiggles on the back of the copies were meaningless. They didn’t even vouch for the accuracy of the photocopying, much less prove the validity of the originals. All the documents would have to be sent back and scattered around the USA for proper authentication, by local Italian consulates. For example, the Italian Consul in Boston had to testify that Harvard was a degree-granting university. Second, the Consular list had omitted a crucial document, the Certificate of Existence in Life. No, the mere observation of me stamping my foot and tearing my hair was not, for the Italian government, sufficient proof that I existed. Yes, a nonexistent person was unlikely to be asking for an Italian medical license, but rules were rules. The Consulate’s final error was a bit of misinformation, bred, perhaps, of tenderheartedness. All these documents couldn’t possibly get me an Italian license. They would merely get me a toehold in the University where they might, at best, be alchemized into an Italian medical degree, but an actual license would be another and rather more difficult question. This was my first lesson in Italian bureaucracy. The Consular official in New York clearly hadn’t had the faintest idea what she was doing and no intention of trying to find out, but she had found me too simpatica to disappoint—a sentiment not strong enough to keep her from abandoning my application to gather dust. By this time various shady sources such as Italian medical professors and representatives of international foundations had suggested an alternative to my quest for the holy grail of doctorly legitimacy: just hang out a shingle and to hell with the license. Unfortunately, I’m such a coward that climbing on a bus without a ticket gives me palpitations, so practicing without a license would be a degree of “transgression” (as the Italians call it) far beyond my talents.

According to two major studies by the National Academy of Medicine, there are 44,000 to 98,000 deaths each year due to medical errors.

Nurse Practitioner Liability and NP Error in New Jersey, US. Nurse Practitioner Liability - Np Error includes Failure to provide oversight, Breach of Contract, Patient is harmed, Harm is Foreseeable in New Jersey, US. According to Recent Case Law Physician had a duty of care to the patient of an NP, even through the Physician never saw or evaluated the patient and the Facts are Dr. had a Collaborative Practice Agreement (CPA) with NP, who owned her medical practice.

I’m ninety-nine percent sure Libby’s going to say yes, but that one percent margin of error is apparently enough to give me a raging case of hyperhidrosis. That’s the name of the medical condition that makes your hands sweat too much. I know this because Libby used it to beat me at Scrabble a few weeks ago. She is not only beautiful, sexy, generous, funny, and thoughtful, but crazy smart to boot.

Administering medications is the nursing activity most associated with errors.

El Departamento de Cirugía del Beth Israel Deaconess Medical Center, un hospital universitario de la ciudad de Nueva York, ha desarrollado algo llamado el «disparador de habilidades laparoscópicas», un «videojuego» basado en la intensidad para el entrenamiento de los cirujanos. Los cirujanos laparoscópicos que durante tres horas a la semana entrenaron con ese vídeo consiguieron bajar sus errores en una tercera parte. Y llevaron a cabo su actuación un veinticinco por ciento más deprisa que quienes no entrenaron.

medical students at Harvard made significant errors5 when calculating the probability that a patient had cancer

Doctors and drugs (medical errors) are the third-leading cause of death in the United States (behind heart disease and cancer). As reported in the Journal of the American Medical Association, over 250,000 Americans die each year from medical therapies, including at least 113,000 from the negative effects of prescription medications.

Psychiatrists see only a biological brain disease. Psychologists see only errors in thinking. That is, if you don’t like yourself, or you feel hopeless, or you see life as fundamentally dissatisfying, you’ve fallen victim to what researchers call “learned helplessness.” By some blend of bad genes and bad experience, you have come to see the world in dark hues. Therapy and medication can help you see the world the way healthy optimists do.

At the same time, mainstream gay activists of the 1970s era who wanted to take out homosexuality as a classificatory category under the DSM saw madness and disability as pathological and did not want to associate with them for fear of medicalization or criminalization. In other words, according to Lewis, declassification activists looked at the diagnosis of homosexuality as an error in an otherwise scientific profession of psychiatry.129 By so doing, declassification activism aided in the legitimation of psychiatry as scientific knowledge, an assertion that was cemented at the end of the 1970s.

types of errors is the most rational thing to do, when the errors are of little cost, as they lead to discoveries. For instance, most medical “discoveries” are accidental to something else. An error-free world would have no penicillin, no chemotherapy…almost no drugs, and most probably no humans.

In 2016 a Johns Hopkins study found that more than 250,000 Americans die each year from preventable medical errors, effectively making modern medicine the third leading cause of death in the US.

ask the doctor: “How much sleep have you had in the past twenty-four hours?” The doctor’s response will determine, to a statistically provable degree, whether the treatment you receive will result in a serious medical error, or even death.

a new report has discovered that medical errors are the third-leading cause of death among Americans after heart attacks and cancer. Sleeplessness undoubtedly plays a role in those lives lost.

Even in surgery there have been some encouraging developments. For instance, operating on the wrong knee or foot or other body part of a patient has been a recurrent, if rare, mistake. A typical response has been to fire the surgeon. Recently, however, hospitals and surgeons have begun to recognize that the body’s bilateral symmetry makes these errors predictable. In 1998, the American Academy of Orthopedic Surgeons endorsed a simple way of preventing them: make it standard practice for surgeons to initial, with a marker, the body part to be cut before the patient comes to surgery.

More people die each year from preventable medical errors in hospitals than from breast cancer and automobile accidents combined.

Additionally, after a thirty-hour shift without sleep, residents make 460 percent more diagnostic mistakes in the intensive care unit than when well rested after enough sleep. Throughout the course of their residency, one in five medical residents will make a sleepless-related medical error that causes significant, liable harm to a patient.

Another very important thing to remember about stages: people move back and forth through them, not just forward in one direction. Change, and a person's readiness for it, very seldom proceeds in a straight line. It goes in fits and starts as people learn along the way. We say this as an anxiety preservative for you. Your loved one may start to think about the issues, start to think about changing, start to make plans; then drop them, return to the old behavior, figure out again it's not working so well, start to think about changing again - all fodder for learning. Keep in mind that people learn things at different paces; some people pick up on certain things quickly, while others have to go through many rounds of trial and error. For each individual, it depends on what he is trying to learn - he may get the hang of managing emotions but take a long time to make new friends, or learn to enjoy parties without drinking, or fall asleep without medication. It is important to try to resist comparing your loved one's, or your own, pace and style of changing with others.' Preconceived notions of how the change process should go will only set you up for disappointment, as change seldom follows a predictable path. By understanding the nonlinear snature of change, you can more readily relate to attitudes and behavior that don't fall neatly in line with a forward march of progress fantasy of change.

The before-after study at BWH showed that CPOE reduced all medication errors by 83% and ADEs by 17% [4]. The estimated cost saving if the system were implemented hospital-wide was $480,000 per year. The controlled study of pharmacist participation on rounds at the MGH showed a 66% reduction of ADEs caused by errors in prescribing [5]. Finally, we had evidence that systems change worked in healthcare.

The paper also influenced the thinking of future leaders in patient safety. Within a year, Jerod Loeb , from the Joint Commission, and Mark Eppinger of the Annenberg Center decided to convene a conference on medical error . Despite the displeasure with Lundberg at the AMA , its legal counsel, Marty Hatlie , convinced the leadership to shift its efforts from tort reform to error prevention . That ultimately led the AMA to found the National Patient Safety Foundation .

The Lehman case was a life-changing event for DFCI , which underwent a major reorganization under the leadership of Jim Conway to dramatically improve its safety and ultimately achieve the lowest medication error rate in the nation.

How many people were harmed by medical treatment in hospitals? What percentage was caused by errors ? By negligence ? Of those harmed by negligent care, how many sued? What were the costs of medical injury —not just for those harmed by bad care, but for all patients, including those who suffered nonpreventable injuries? How were these costs paid for? All was unknown. All was potentially knowable.

It seemed inescapably clear that healthcare needed to take a systems approach to medical errors . We needed to stop punishing individuals for their errors since almost all of them were beyond their control, and we had to begin to change the faulty systems that “set them up” to make mistakes. We needed to design errors out of the system. I had no doubt we could do that.

The Harvard Medical Practice Study confirmed what smaller studies had shown earlier—that nearly 4% of patients in acute care hospitals suffered a significant injury from their medical treatment. What was shocking, and previously totally unrecognized, was that two-thirds of those injuries resulted from errors

I wanted to work on quality improvement; injury and costs were clearly quality issues. At the time, I had not thought much about medical errors

What got attention was the estimate that there were up to 98,000 preventable deaths a year due to medical errors . That number also headlined the newspaper stories the next day.

WebM&MTo engage and inform physicians, AHRQ initiated WebM&M, using the familiar format of mortality and morbidity rounds to make available analysis of real-world medical error cases by experts, monthly.

Further analysis showed that disclosure of the AE to the patient by the medical team only occurred 40% of the time. Disclosure was more likely if additional treatment was needed and less likely if the AEs were preventable (an error ). Patients were twice as likely to rate the quality of care high when there was disclosure [4]. High patient participation in their care was associated with fewer AE (49%) and higher likelihood that patients would rate the quality of their care good or excellent [5

We've all read a thousand articles that say marriage makes you healthier and happier. Umm, no. Many of these studies merely survey married people and single people, compare the happiness levels, find that the married people are doing better, and crow "See? Marriage makes you healthy and happy." But that's committing an error called "survivorship bias." If you want to determine if getting married makes you happier, you need to include separated, divorced, and widowed people in with the currently married, not with the unmarried... A 2010 study from Australia even said previous research probably underestimated just how happy people in happy marriages are. But the flip side is even more damning than you may have guessed. A study of medical records of five thousand patients analyzed the most stressful life events people deal with. Divorce came in #2 (Death of a spouse was number one.) Divorce even beat going to prison.

First, I am thrilled that paramedics are finally getting the respect they deserve for being the professionals they can be. The scope of practice is expanding, and patient care modalities are improving, seemingly by the minute. Patient outcomes are also improving as a result, and EMS is passing through puberty and forging into adulthood. On the other hand, autonomy in the hands of the “lesser-motivated,” can be a very dangerous thing. You know as well as I do that there are still plenty of providers who operate from a subjective, complacent, and downright lazy place. Combined with the ever-expanding autonomy, that provider just became more dangerous than he or she ever has been – to the patients and to you. Autonomy in patient care places more pressure for excellence on the provider charged with delivering it, and also on the partner and crew members on scene. Since the base hospital is not involved like it once was, they are likewise less responsible for the errors and omissions of the medics on the scene. Now more than ever, crew members are being held to answer for the mistakes and follies of their coworkers; now more than ever, EMS providers are working without a net. What’s next? I predict (and hope) emergency medical Darwinism is going to force some painful and necessary changes. First, increasing autonomy is going to result in the better and best providing superior patient care. More personal ownership of the results is going to manifest in outcomes such as increased cardiac arrest survival rates, faster and more complete stroke recovery, and significantly better outcomes for STEMI patients, all leading to the brass ring: EMS as a profession, not just a job. On the flip side of that coin, you will see consequences for the not-so-good and completely awful providers. There will be higher instances of licensure action, internal discipline, and wash-out. Unfortunately, all those things will stem from generally preventable negative patient outcomes. The danger for the better provider will be in the penumbra; the murky, gray area of time when providers are self-categorizing. Specifically, the better provider who is aware of the dangerously poor provider but does nothing to fix or flush him or her, is almost certain to be caught up in a bad situation caused by sloppy, complacent, or ultimately negligent patient care that should have been corrected or stopped. The answer is as simple as it is difficult. If you are reading this, it is more likely because you are one of the better, more committed, more professional providers. This transition is up to you. You must dig deep and find the strength necessary to face the issue and force the change; you have to demand more from yourself and from those around you. You must have the willingness to help those providers who want it – and respond to those who need it, but don’t want it – with tough love by showing them the door. In the end, EMS will only ever be as good as you make it. If you lay silent through its evolution, you forfeit the right to complain when it crumbles around you.

In the late 1980s, the Department of Veterans Affairs Medical Center in Lexington, Kentucky, became the first hospital in the United States to tap the power of the mea culpa. It informs patients and their families when any staff member makes a mistake that causes harm, even if the victims are unaware of the error. If the attending physician is found to be at fault, he or she must deliver a clear, compassionate apology to the patient. The hospital also explains the steps it will take to ensure the error does not happen again and may offer some form of restitution. But the cornerstone of the new regime is the simple act of saying sorry. This scores well with patients and their families. “We believe we spend much less time and money on malpractice lawsuits these days as a result,” says Joseph Pellecchia, the hospital’s chief of staff.

The promise of artificial intelligence in medicine is to provide composite, panoramic views of individuals’ medical data; to improve decision making; to avoid errors such as misdiagnosis and unnecessary procedures; to help in the ordering and interpretation of appropriate tests; and to recommend treatment.

As a registered nurse, Richards knew many of the mistakes occurred when highly trained, well-intentioned people made very human errors that were often a result of a work environment filled with distracting external triggers. In fact, studies found nurses experienced five to ten interruptions each time they dispensed medication.

Category errors that redefine the members of a privileged class as members of an oppressed class are particularly pernicious because they replicate the existing social hierarchies. Men who claim to be women, for example, still exploit, abuse and subjugate women, only they do this from within the women's movement, dismantling women's right to single sex spaces and silencing discussions about uniquely female experiences.

It’s free,” said the Chan Zuckerberg person. “There was this super-long pause,” said Joe, who was on the line. “We don’t know how to do no-cost,” said Zuckerberg. “What do you mean?” asked Chan Zuckerberg. “It shows up as an error in the hospital computer if we put zero cost,” said Zuckerberg. “It won’t accept zero.” “Can’t you put like one-tenth of a cent?” asked Joe. They couldn’t. The system wouldn’t allow it. It was Balamuthia all over again. The cure meant nothing if the patient never received it. Standing between the cure and the patient, in this case, was a U.S. medical-industrial complex that lurched between lethargy and avarice. Joe had never really had to understand its inner workings. Now he began to see that the incentives of virtually everyone in it were screwed up. To do something as simple as accept an offer of free coronavirus testing required either unusual effort or real courage.

Those transitions provide a lot of opportunities for things to fall through the cracks, so it shouldn’t come as a surprise that following hospital discharge nearly half of hospitalized patients experience at least one medical error in medication continuity, diagnostic workup, or test follow-up.51

In 1895, Dr. William Mayo addressed the graduating class of the medical department of the Minnesota State University on the importance of thoroughness in medicine: Above all things let me urge upon you the absolute necessity of careful examinations for the purpose of diagnosis. My own experience has been that the public will forgive you an error in treatment more readily than one in diagnosis, and I fully believe that more than one-half of the failures in diagnosis are due to hasty or unmethodical examinations. Say to yourselves that you will not jump at a conclusion, but in each instance will make a thorough and painstaking physical examination, free from prejudice, and your success is assured. 14

We finally settled on “adverse event .” We spent many hours debating its exact definition and ultimately agreed on “an unintended injury that was caused by medical management rather than the patient’s underlying disease.” The important point was to distinguish harm caused by treatment from harm caused by disease, independent of whether there was an error or negligence . We knew that making this judgment would be difficult for doctors, as it indeed proved to be.

The benefits of procrastination apply similarly to medical procedures: we saw that procrastination protects you from error as it gives nature a chance to do its job, given the inconvenient fact that nature is less error-prone than scientists.

Use Error is defined as a “user action or lack of user action while using the medical device that leads to a different result than that intended by the manufacturer or expected by the user

A recent RAND Corporation report illustrates these points precisely, finding that preventable medical errors in hospitals result in tens of thousands of deaths per year; preventable medication errors occur at least one and a half million times annually; and, on average, adults receive only 55 percent of recommended care, meaning that 45 percent of the time, our doctors get it wrong.