Medical errors cause high casualties in U.S., study says

Ordinary medical errors may be the third leading cause of death in the United States, reports a terrifying new study in the BMJ (formerly the British Medical Journal).

Patient safety researchers from Johns Hopkins University School of Medicine estimate 251,000 Americans die each year from common mistakes in hospitals and other health-care facilities.

That’s about 700 people a day. Let’s set this number in context. The number one and number two annual killers are heart disease with 614,348, and cancer, with 591,699 deaths, according to the National Center for Health Statistics.

Lead researcher Martin Makary told the Washington Post, “Categories include everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another.”

Not afraid yet? Dr. Makary told the newspaper, “It boils down to people dying from the care that they receive rather than the disease for which they are seeking care.”

Maybe I’ve been watching too many old John Wayne movies, but I don’t think this is a new problem. I suspect Old West doctors may have given too much laudanum for gunshot wounds. Civil War battlefield surgeons sometimes amputated the wrong limb.

How can this be happening in our technology-riddled medical system?

Fallible humans are in charge and bear ultimate responsibility.

Because seniors often experience complicated medical problems with complex, lengthy treatments, we are more susceptible to errors. We must advocate for ourselves, or have someone who does it for us. While not everything is preventable, our representative can be another set of eyes and ears, both in a hospital and health-care setting, or in the home.

With some forethought, we can possibly eliminate some errors.

Before you need a hospital or health-care setting

1. Keep all documentation related to your medications. If you use a medication management system, keep the most recent prescription bottle. You may need to confirm name or dosage of the pill.

2. Organize all paperwork. Buy a tabbed binder and sort by type of doctor (urologist, family practice, oncologist). Many doctor’s offices offer a print-out of all medications after each visit. Keep in the binder and give one to your caregiver. (My father’s long-term care facility recommends keeping information in the freezer or, as a friend was advised, attached to the outside of it with a magnet, where family or EMS can find it.)

3. Have an advanced directive and an appointed health care representative. Visit http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289 for your state’s requirements.

4. None of this matters if you have not communicated to a loved one or your health-care representative. Keep them updated when changes happen.

5. Choose a provider or facility with care. Use the internet or have your representative check out your doctor and any potential facility you may visit. Having knee surgery, consider the hospital known for orthopedics.

In a hospital or health-care setting

1. When admitted to a facility for a lengthy stay or one that lasts a few hours, bring all medications in original bottles, and all paperwork that you’ve organized ahead of time.

2. Know why you are there – your condition and what tests or procedures are ahead. Most providers give material ahead of time. I recently had a cardiac stress test. The hospital provided an easy-to-read brochure that explained what was going to happen to me, and why.

3. Ask the caregiver to double check your wristband before every medication or procedure. Your representative can do this also if you are sleepy or unconscious. Many people have a family member bunk overnight during a hospital stay.

4. Ask questions about anything you do not understand or feel is unusual or uncomfortable. The staff is there to help you. If you do not understand something, ask.

5. Let your primary care office know you are in the hospital. Most physicians no longer make rounds in hospitals, but you can always call to ask a question. A hospitalist will care for you during a hospital stay.

6. Don’t play with the hospital bed. Unless you have an electronic bed at home, ask for help. If the rails need to be up, keep them up so you can sleep safely. You are in a strange environment, possibly medicated. A broken hip is not worth it.

7. Make sure every provider coming or going washes his hands. This is patently obvious, but humans sometimes forget. Hospitals are germ-ridden places, and someone can easily transmit something ugly and contagious.

With humans running the show, mistakes happen. Minimize your risk by finding someone who’ll have your back. And pay attention.