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Articles Tagged with medical error

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Patient wristbandPatient identification error may be medical malpractice that can result in serious injury and sometimes death of a patient. This type of medical error can happen at any step of a medical process from lab testing to medication administration and even billing.

A special report published by the ECRI Institute reviewed 160 recent scientific searches and publications written on this type of medical malpractice to provide a snapshot of the status of this prevalent occurrence.

The report found patient  identification errors at each of the following clinical contexts:

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African American Patient with DoctorsMedical Malpractice may have been committed on many American Africans who were previously diagnosed with hypertrophic cardiomyopathy.  A recent study found that some genetic variations that were linked to this condition were indeed harmless. These specific genetic variations were found more often in black Americans than in white Americans. Therefore many patients from African descent may have been misdiagnosed or are still being treated for a condition they don’t suffer from.

Also called, abnormally thick heart muscle, hypertrophic cardiomyopathy is a genetic disease that affects 1 out of 500 Americans. The disorder can cause arrhythmia and can be fatal. Symptoms may include chest pain, difficulty, breathing, fatigue and swelling in the ankles and feet. For a complete list and diagnostic testing see The American Heart Association web site. Sometimes there are no symptoms.

Abnormally thick heart muscle is diagnosed through genetic testing. A patient who tests positive for  the condition will often be required to change his or her lifestyle. These changes may include healthy diet, additional physical activities, losing excessive weight or stopping smoking. Patients diagnosed with hypertrophic cardiomyopathy  are often prescribed specific medication to treat the condition.  Various types of surgeries are also commonly used as well as  alcohol septal ablation, a noninvasive procedure.

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220px-Surgeons_at_Work251,000 people died from medical error in the US in 2013. This was the third highest cause of death that year  in the US after cancer (585,000) and heart disease (611,000) according to estimates calculated by Martin A Makary, professor and Michael Daniel, research fellow at the Department of Surgery of Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

In a recent article published in the British Medical Journal, Martin Makary and Michael Daniel explain the difficulty of obtaining the exact numbers of people dying from medical malpractice in the US and how they “analyzed the scientific literature on medical error to identify its contribution to US deaths in relation to causes listed by the CDC“.

Every year the Center for Disease Control and Prevention (CDC)  compiles data from death certificates to prepare statistics related to causes of death in the U.S. On death certificates the cause of the death is coded according to an International Classification of Disease (ICD). The CDC is using the ICD codes to prepare its yearly statistics but these codes do not capture human or system errors.  Deaths certificates from patients dying in hospitals will list a medical condition but not a medical error.

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Urgent Care Centers have been opening all around New York City and the US these recent years  but are they really safe? Here are the most common acute care medical malpractice risks:

  • Patient is being send home with a very abnormal vital sign without a re-evaluation of that abnormal sign
  • Poor risk factor evaluation happens when  practitioners forget to ask important questions about the medical history of the patient
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Among the various types of medical malpractice suffered by hospital patients, misdiagnosis accounts for approximately 10% of patient deaths. In a recent Opinion Page from the New York Times, Sandeep Jauhar, a Long Island cardiologist, wants to Bring Back the Autopsy as a weapon to fight misdiagnosis.

With the evolution of medicine and the proliferation of medical tests, autopsy doesn’t seem as essential these days as it was in the past to determine the cause of death of a patient. Before 1971, community hospitals were required to perform autopsies on 20% of their dead patients to earn their accreditation from the Joint Commission. This requirement was dropped after that date. Furthermore in 1986, Medicare considered autopsies financially draining and stopped paying for them. Now an autopsy is mostly considered by doctors as an educational tool.

Recent studies however have demonstrated that despite the medical technological advances autopsy can be a very effective manner to reduce the rate of hospital misdiagnosis.  In his opinion Sandeep Jauhar suggests that Medicare and private insurers pay for them again so that financial considerations doesn’t limit their use.




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Face InjectionsThe FDA is warning that in rare cases  unintentional injections of soft tissue fillers into blood vessels in the face can block blood vessels and restrict blood supply to tissues and in the worst cases result in embolization. The filler could travel to another part of the body and could cause vision impairment, blindness, stroke and damage and/or death of the skin (necrosis) and underlying facial structures.

Soft tissue fillers are mostly use by dermatologists and cosmetic surgeons to reduce the appearance of wrinkles or to augment cheeks or lips. Ophthalmologists, neurologists, and neurosurgeons also use them for other medical procedures.

If you are considering injecting soft tissue fillers in your face, make sure that your health care provider is board certified, has appropriate training and experience and is knowledgeable about the anatomy at and around the injection site.

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Operation Provide HopeWhen medical malpractice or medical error occurs at an American hospital or clinic, the victim of the malpractice or his or her family has the right to legally challenge the facility and obtain explanations and compensation.  The story is very different for the 1.3 million active-duty service members of our nation. Not only are they captive of the military medical system and can’t get care elsewhere without special approval but also if medical malpractice is committed they have no legal right to bring a medical malpractice suit. In a recent article in the New York Times, Sharon LaFraniere investigates this issue and describes the nightmares that many military families are enduring.

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Patient SafetyMedical errors and adverse events are among the leading causes of death and personal injury in the U.S. According to a recent study in the Journal of Patient Safety  the number of premature deaths associated with preventable harm to patients is estimated at more than 400,000 per year. Serious harm seems to be 10- to 20-fold more common than lethal harm.

The patient safety awareness week is an annual campaign led by the National Patient Safety Foundation to create awareness about patient safety among healthcare providers and their patients. The campaign is running this week and the subject is “United in safety” . The emphasis is on better communication between healthcare providers and patients to reduce adverse events or medical errors.

Tomorrow Wednesday March 11th at 8:30 pm ET anyone interested can join a twitter chat on patient and family engagement using  #PSAWunited to participate. People interested can also join a free webcast on patient safety on Thursday March 12th.

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medical_device_alarm_safety_infographic.jpgHere is the 2014 top 10 Health Technology Hazards just released by the ECRI Institute. This list is developed every year and highlights the health technology safety topics that the ECRI Institute’s Health Devices Group believes warrant the most attention for the coming year.


1. Alarm Hazards (click on infographic to enlarge)

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An elderly woman with an history of pancreatitis was admitted for an emergency laparotomy after she showed symptoms of acute abdominal pain, nausea and vomiting. The diagnosis was small bowel obstruction. Her heart stopped during anesthesia and she had to be resuscitated and sent to the ICU. She died there the day after. The hospital’s case review committee concluded it was a misdiagnosis: the patient suffered acute pancreatitis and not a small bowel obstruction therefore surgery was contraindicated and death could have been prevented. This type of cases raises questions about the decision process in emergency surgery, specifically for elderly people. The complete case as well as a medical commentary, references and World Health Organization Surgical Safety Checklist can be found at Web M&M.