Patient Safety and RA: Preventing Medical Errors
When people think of safety and RA, they mostly think of medications and lifestyle issues. But patient safety involves much more than that.
In 1999, the Institute of Medicine (IOM) released what was at the time a groundbreaking study about medical errors, which was aptly titled, “To Err Is Human: Building A Safer Health System”. At the time, the study estimated that about 100,000 people per year died from preventable medical errors.
Some, including Forbes, have criticized the report for grossly underestimating medical errors. As of 2014, over 400,000 people a year die from medical errors (McCann, 2014). That’s more than 1,000 patients per day, making death by medical error the third leading cause of death in the United States, only surpassed by heart disease and cancer. Further, there are nearly 10,000 cases per day of complications that are a direct result of medical error (McCann, 2014).
For patients with RA, safety starts at diagnosis. According to the IOM report, delayed or improper diagnosis is considered to be a preventable medical error. For many RA patients, it takes years to get a correct diagnosis, which means valuable time lost in treating the disease. Many of us have had test results that were problematic, but we were somehow never told about them. According to the IOM report, this too is considered a medical error.
Most RA patients experience a hospitalization at one time or another. There is a lot that can happen in the hospital, especially if you are there for a significant amount of time and are seen by many different doctors. You can be given the wrong medication, or the right medication with the wrong dose. When I was in the hospital, I was once given a blood thinner. After the first dose, I asked why it was being given to me and was informed that I take it at home. I have never taken a blood thinner in my life That’s a medical error. And even though I didn’t die from this mistake, it brings home that one wrong injection could meant the difference between life and death.
I think we often don’t realize that things that might not kill us are an issue. But medical error does not just include the extreme cases where an instrument or sponge is left inside a patient after surgery. Communication failure between doctors and patients is also considered a medical error by the IOM.
A Preventable Error
Sometimes, despite our best efforts to be dutiful patients, we are caught in the crosshairs of medical error, no matter how hard we try and avoid it.
I know that because it happened to me. My rheumatologist told me to get a pneumonia vaccine. I ended up having to get it done at the student health center and not the hospital where my rheumatologist was. When the nurse swabbed my arm, I commented that she swabbed it much lower on the arm than normal. She assured me that was how it was done (wrongly, it turns out).
To make a long story short, I ended up in the hospital with a severe case of cellulitis, in which I almost lost my arm, and could have lost my life. I did everything my doctor told me to do, and I still ended up being the victim of a preventable medical error.
I think that is why medical errors are so scary. Most of the time, the patient isn’t even aware that something has gone wrong until it is too late. As patients, we trust our medical providers with our lives. And sometimes, they drop the ball, which can have devastating and deadly consequences.
To put this into perspective, according to the Centers for Disease Control and Prevention (CDC), in 2014, there were 35.1 million hospital patient discharges and 136.3 million emergency department visits. If we divide 400,000 by 35 million, we get just about 1 percent. That means that 1 percent of patients die per year as a result of preventable medical errors. That, in my opinion, is 1 percent too many.
In 2012, according to an article in The New York Times, there was talk about creating a national reporting system where patients could report that they had been the victim of a medical error. Despite this, to date, nothing exists for patients to report such errors.
What to Do If You’re the Victim of a Medical Error
If you believe you are the victim of a medical error, it’s important to contact the doctor and/or hospital where the error took place. You can also file a complaint with the Joint Commission, the Centers for Medicare & Medicaid Services, or with your state health department or medical board. Any complaints filed to any of those bodies have to be investigated.
Go with your gut. If you believe that you have been the victim of a preventable medical error, don’t be quiet. Say something.
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Leslie wrote for HealthCentral as a patient expert for Rheumatoid Arthritis (RA).