ARTICLE: Report: Medical mistakes kill thousands each year

The Topeka Capital-Journal 
Nov 30, 1999 

The Associated Press

WASHINGTON --- Medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans a year, says a new report that calls the errors stunning and demands major changes in the nation's health- care system to protect patients.

The groundbreaking report by the Institute of Medicine says there are ways to prevent many of the mistakes and sets as a minimum goal a 50 percent reduction in medical errors within five years.
 
The problem is less a case of recklessness by individual doctors or nurses than it is the result of basic flaws in the way hospitals, clinics and pharmacies operate, the report says. The institute cited two studies that estimate hospital errors cost at least 44,000, and perhaps as many as 98,000, lives, but research on the topic is unable to pinpoint fatalities more precisely.

Doctors' notoriously poor handwriting too often leaves pharmacists squinting at tiny paper prescriptions. Did the doctor order 10 milligrams or 10 micrograms? Does the prescription call for the hormone replacement Premarin or the antibiotic Primaxin?

Too many drug names sound alike, causing confusion for doctor, nurse, pharmacist and patient alike. Medical knowledge grows so rapidly that it is difficult for health-care workers to keep up with the latest treatment or newly discovered danger. Technology poses a hazard when device models change from year to year or model to model, leaving doctors fumbling for the right switch.

And most health professionals don't have their competence regularly retested after they are licensed to practice, the report said.

Indeed, health care is a decade or more behind other high-risk industries in improving safety, the report said. It pointed to the transportation industry as a model: Just as engineers designed cars so they can't start in reverse and airlines limit pilots' flying time so they are rested and alert, so can health care be improved.

But the Institute of Medicine concluded that reducing medical mistakes requires a bigger commitment, and recommended some immediate steps:

- Establish a federal Center for Patient Safety in the Department of Health and Human Services. Congress would have to spend some $35 million to set it up, and it eventually should spend $100 million a year in safety research, even building prototypes of safety systems. Still, that represents just a fraction of the estimated $8.8 billion spent each year as a result of medical mistakes, the report calculated.

- The government should require that hospitals, and eventually other health organizations, report all serious mistakes to state agencies so experts can detect patterns of problems and take action. About 20 states now require such reports, but how much information they require and what penalties they impose for errors varies widely, the report said.

- State licensing boards and medical accreditors periodically should re-examine health practitioners for competence and knowledge of safety practices.

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