Patients Urged to Guard Against Medical Errors

In two separate articles from Intelihealth dated January 28, 2002 patients are warned they themselves are the best defense against medical errors. The first article starts by relaying two tragic cases in the same week, about serious surgical mistakes in hospitals. In Connecticut, two women died during surgery when they were accidentally given nitrous oxide instead of oxygen. In Rhode Island, a man had a successful brain operation, but only after the surgeon first drilled into the wrong side of his skull.

A preponderance of these types of problems led the Institute of Medicine of the National Academy of Sciences to release a report in 1999 titled: "To Err Is Human: Building a Safer Health System" a private institute which is an advisory body to the U.S. government. Their report estimates that 44,000 to 98,000 deaths occur each year in hospitals alone as the result of medical mistakes.

Stressing the role that the patient needs to take, an instructor of medicine at Harvard Medical School, Dr. Gandhi, says patients need to keep involved and ask questions. "Nurses, pharmacists and physicians all double-check things, but the patient is the last check." Some experts are recommending that patients or doctors in advance mark the spot to be operated on with permanent marker.

Lifeline Subscribers and CaregiversKenneth W. Kizer, M.D., M.P.H., president of the National Quality Forum, says, "If you're getting surgery on a knee, for instance, make sure the correct side is marked 'yes' and the wrong side 'no'. Make sure all staff members in the operating room know what procedure they are going to perform. Say, 'We're operating on my right leg, right?' Patients tend to be too bashful to do that. They assume that everybody knows. Patients should never assume anything," he concluded.

The Joint Commission on Accreditation of Healthcare Organizations, the U.S. government's Agency for Healthcare Research and Quality, developed some recommendations that patients should utilize themselves. These include:

• Take part in every decision about your health care. Ask questions, and speak up about anything that you don't understand or that causes you concern.
• Keep a list of everything you take. Make sure you know the dosages and the purpose of the medicines. Read medicine labels, including warnings. Learn what side effects to watch out for, whether the medicine has dangerous interactions with other drugs, and whether you should avoid certain activities — such as drinking alcohol or spending time in the sun — while you are taking it.
• Make sure the medicine you receive is what the doctor actually prescribed. If it looks different than what you expected, ask the pharmacist about it.
• Ask the people who care for you if they have washed their hands. This may make them wash more often.
• Insist that your surgeon write his or her initials or words such as "yes" or "this side" (in permanent ink) on the part of the body that is supposed to be operated on.