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    Wednesday, September 25, 2002

    Medical Error Myth: The Bloviator had a post yesterday that highlighted a speech by Treasury Secretary O’Neill about cutting healthcare costs by cutting medical error rates. Now, I sincerely believe that medical errors are bad and should be eliminated as much as possible, but I take exception to comments like this:

    At least 100,000 Americans every year die because of medical errors and mistakes. A just released study by the Archives of Internal Medicine indicates that medication errors alone occur 2 times a day, per patient, in a typical hospital. -from Secretary O’Neill’s speach

    That figure of 100,000 people dying each year comes from the Institute of Medicine’s study on medical errors from a couple of years ago. The study was poorly designed and its results have been largely discredited, but the IOM did such a fine job of grandstanding that their exaggerated and incorrect figure has taken on a life of its own. The Republicans repeat it, the Democrats repeat it, the HHS repeats it, advocacy groups like Public Citizen repeat it, and worst of all the American Trial Lawyers repeat it - again and again.

    Counting errors is an imprecise science. The results depend on how errors are defined, and in the IOM report they were defined as any adverse event. Every medical decision, even when it’s the right decision, has the potential to have an adverse effect. For example, an antibiotic might be chosen for a deadly infection because it’s the one that offers the best chance of survival for the patient. The patient lives, but has an allergic reaction to the antibiotic. By the IOM standards this would count as a mistake. What it really is, is an adverse reaction, and one that we have no way of predicting. Similarly, the quote on medication dosing errors includes failures to deliver medication on time. This isn’t necessarily a mistake - the patient could be off the floor for testing when their scheduled dose is due, or the nurse could be busy attending to another critically ill patient and miss the scheduled dose. Getting your medicine an hour later than scheduled isn’t really an error, and it isn’t likely to make a difference in the course of an illness.

    posted by Sydney on 9/25/2002 06:45:00 AM 0 comments


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