Last July I had surgery in a major teaching hospital. This did not make me happy because the last place you want to have surgery, especially if you are a "senior" (that affectionately condescending euphemism for the "elderly") is in a teaching hospital. And the last month you ever want to have surgery in a teaching hospital is July. That's because rotations occur then: new interns come on board and first, second and third year residents take up their new positions. They are all eager to learn and to do new things, and each newly elevated doc can't help but feel a little bit cocky, if frightened, by the new authority with which they've just been invested.
That's why I told my surgeon, the anesthesiologist, and anyone else who would listen that if any of their underlings messed me up, I'd have their hearts for dinner. Sure enough, a newly minted third year resident ordered my catheter removed prematurely which resulted in some pretty unpleasant things, including a bladder infection.
Bladder infections resulting from catheterization are categorized as "adverse events". That is, they cause harm to a patient but are not serious. Serious events are called "never events" and they include such horrors as surgery on the wrong patient or other things that "should never occur in a health care setting", according to a report issued by the Department of Health and Human Services in November.
The report, "Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries," found that an estimated 13.5 percent of hospitalized people on Medicare experience adverse events during their hospital stays. An additional 13.5 percent of Medicare patients experience "temporary harm events" requiring an intervention during hospitalization. An estimated 44 percent of adverse and temporary harm events are deemed to be preventable. Most of these events are linked to medical errors, substandard care, and lack of patient monitoring and assessment.
According to a report by the Institute of Medicine published in 2000, studies indicate that as many as 98,000 Americans may be dying annually as the result of medical errors. "More people die in a given year as a result of medical errors than from motor vehicle accidents, breast cancer, or AIDS," says the report, "To Err is Human: Building a Safer Health System."
More recently, a study published in The New England Journal of Medicine in November revealed that research conducted between 2002 and 2007 found that the number of "events" has not diminished. Complications from procedures, drugs, and hospital-acquired infections are still all too common. Many of the problems identified in this study were caused by hospitals' failure to carry out and enforce protocols that have been proven to avert mistakes and prevent infections.
I was one of the lucky ones. My "event" was merely "adverse" and I recovered quickly with the help of antibiotics. But many others, especially if they are "seniors", don't get off so easily. Some of them end up with the wrong limb amputated, or worse: they die because of medication errors.
Clearly, as one California physician declared to The New York Times, "We need to do more and to do it more quickly." Duh. We need to do more, more quickly because it will save lives, money, litigation, and a whole lot of aggravation and suffering.Besides, who wants to have to eat hearts for dinner?