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Medical Malpractice: Medical Mistakes Happen

In July of 2000, JAMA (Journal of the American Medical Association) published that physician mistakes were the third leading cause of death in the United States.  Thus the question, over the last 20 years and during the Covid Pandemic did the attention to medical errors make the situation better?

Deaths Per Year (From 2000)

  • 12,000 — unnecessary surgery
  • 7,000 — medication errors in hospitals
  • 20,000 — other errors in hospitals
  • 80,000 — infections in hospitals
  • 106,000 — non-error, negative effects of drugs

These total to 225,000 deaths per year from physician or health care mistakes and are only surpassed by heart disease and cancer.

Medical Mistakes Are Commonplace

According to a 2011 Health Grades report,3 the incidence rate of medical harm occurring in the U.S. was estimated to be over 40,000 harmful and/or lethal errors daily. Makary cites a 2014 Mayo Clinic survey of 6,500 American doctors, 10.5% of whom admitted they’d made a major medical mistake in the last three months.

He also cites a 2015 study by researchers at Massachusetts General Hospital that showed about half of all operations involved some kind of medication error. That study and corresponding press release have since been removed and are no longer available online, Makary says. Possibly because the hospital was embarrassed by the results.

In 2016, Makary and his research team published a report showing an estimated 250,000 Americans die from medical mistakes each year4 — about 1 in 10 patients — which (at that time) made it the third leading cause of death, right after cancer and heart disease.

According to Makary, that number may be higher, because the Centers for Disease Control and Prevention does not collect vital statistics on medical errors. A death cannot be recorded as a medical error as there’s no code for it.

Of course, since they didn’t do autopsies on every death, that number could also be lower, so the final estimate they came up with was between 125,000 and 350,000 deaths per year.

Another widely-cited study5 published in 2013 had estimated the annual death toll for medical mistakes in the U.S. at 400,000 a year,6 Makary says. But whatever the true number, and whether it’s the third cause of death or the ninth, medical mistakes are clearly a serious and too-frequent problem.

An estimated 30% of all medical procedures, tests and medications may also be completely unnecessary,7 and each of these unnecessary interventions opens the door for a medical mistake that didn’t need to happen.

Many doctors have long been concerned about the frequency of medical mistakes, unnecessary testing and overtreatment, but the culture was such that it dissuaded open discussion and transparency.

It’s really only in the past decade or so that doctors and hospital administrators have started being more honest about these problems. Now, a case (discussed below) in which a nurse was charged and found guilty of negligent homicide after accidentally administering the wrong medication threatens to undo much of that progress.

The RaDonda Vaught Case

Vaught was hired as a nurse at Vanderbilt hospital in 2015. Two years later, on Christmas eve in 2017, she was taking care of a patient named Charlene Murphy, a 75-year-old woman admitted for a subdural hematoma (a brain bleed). Murphy made a rapid recovery and after two days she was ready to go home.

The doctor ordered one last scan while she was in the hospital, so Vaught brought her to the scanner and ordered Versed (midazolam), a sedative commonly used to help the patient lay still. The hospital had installed an automated drug dispensary system, the alerts of which often had to be overridden due to poor coordination between the electronic health records and the pharmacy.

On this fateful day, Vaught typed “ve” into the system to pull up Versed, but by default, the system populated the search with “vecuronium,” a potent paralyzing agent. Vaught didn’t realize the mistake, and overrode the alert. Now, vecuronium is a powder, and most experienced nurses would know that Versed is a liquid.

Vaught, however, didn’t catch the discrepancy and suspended the powder with saline as indicated and gave it to Murphy, who subsequently died inside the scanner.

“The nurse [Vaught] immediately feels horrible; says exactly what she did, recognized her mistake as the patient was deteriorating, and felt ‘I may have caused this,’” Makary says. “[She] admitted [and] reported this whole thing; was 100% honest. I mean, [she] even said, subsequently, that her life will never be the same, that she feels that a piece of her has died.”

In 2019, Vaught was indicted for reckless homicide.11,12 She was found guilty and in May 2022, was sentenced to three years probation with judicial diversion,13 which means her criminal record can be expunged if she serves her probationary period with good behavior. Her nursing license was also revoked.

Should Medical Mistakes Be Prosecuted?

Now, while Vaught immediately admitted her mistake, Vanderbilt hospital, for its part, appears to have been trying to cover it up.

“Vanderbilt had documentation where two neurologists listed the cause of death as the brain bleed. It was deemed, essentially, a natural cause of death. This was reported to the medical examiner,” Makary says.

An investigation by the Tennessean revealed Vanderbilt did not report the death to state or federal officials as a preventable adverse event, as is required by law. Instead, they fired Vaught and immediately negotiated an out-of-court settlement with the family, which included a gag order.

So, it wasn’t the family that brought charges against Vaught but rather a team of district attorneys in Davidson county. Vaught’s case is the first of its kind, and has triggered emotional reactions across the country among doctors and nurses alike, as everyone knows how easily and frequently medical mistakes occur.

US Is an Unmitigated Failure at Treating Chronic Illness

The U.S. ranks last in health and mortality when compared with 17 other developed nations. We may have one of the best systems for treating acute surgical emergencies, but the American medical system is clearly an unmitigated failure when it comes to treating chronic illness.

In all, preventable medical mistakes may account for one-sixth of all deaths that occur in the U.S. annually.14 To put these numbers into even further perspective, medical mistakes in American hospitals kill four jumbo jets’ worth of people each week.15

According to statistics published in a 2011 Health Grades report,16 the incidence rate of medical harm occurring in the U.S. may be as high as 40,000 harmful and/or lethal errors DAILY. 17

Safeguarding Your Care While Hospitalized

Knowing that medical errors can and do frequently occur, what can you do to ensure your safety, or the safety of a loved one, who has to go to the hospital?

Once you’re hospitalized, you’re immediately at risk for medical errors, so one of the best safeguards is to have someone there with you. Dr. Andrew Saul has written an entire book20 on the issue of safeguarding your health while hospitalized.

Frequently, you’re going to be relatively debilitated, especially post-op when you’re under the influence of anesthesia, and you won’t have the opportunity to see the types of processes that are going on. This is particularly important for pediatric patients and the elderly.

It’s important to have a personal advocate present to ask questions and take notes. For every medication given in the hospital, ask questions such as: “What is this medication? What is it for? What’s the dose?” Most people, doctors and nurses included, are more apt to go through that extra step of due diligence to make sure they’re getting it right if they know they’ll be questioned about it.

If someone you know is scheduled for surgery, you can print out the WHO surgical safety checklist and implementation manual, which is part of the campaign “Safe Surgery Saves Lives.” The checklist can be downloaded free of charge here. If a loved one is in the hospital, print it out and bring it with you, as this can help you protect your family member or friend from preventable errors in care.

Safeguarding Your Care after Medical Errors Occur

If you believe medical errors may have occurred it is important to understand that most states have time limits in which to seek recovery.  Gather your medical records, bills, pictures, and other evidence and speak with an attorney that knows medical malpractice work.  These are complex cases that require many hours of hard work, years of litigation, and experienced knowledge.  Winslow Law has over 16 years of experience with medical malpractice and would be happy to serve you and your loved ones.

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