Sources: HEALTH LETTER Date: August 1995 Title: “Hospital Errors” Author: Excerpted from ABC “Nightline” (7/4/95) transcript; NEWSDAY Date: 7/17/95 Title: “No mortality rate stats for hospitals”; Author: Thomas Maier
SYNOPSIS: More people are killed or seriously injured in U.S. hospitals annually than from airline and automobile accidents combined.
An estimated 1.3 million people a year receive some kind of injury related to treatment at hospitals, and 180,000 of those people die.
About half of these deaths—80,000 to 90,000 of them—are preventable, the result of negligence, such as prescribing the wrong medicine, receiving the wrong dose of medication, or adverse drug interactions.
The first in-depth look at how often such drug errors occur was published in the July 5, 1995, issue of the Journal of the American Medical Association (JAMA).
The JAMA report revealed that there were 6.5 drug complications for every 100 admissions to the hospital. The major problems were four areas: the wrong drug or the wrong dose; incorrect copies of the drug order; pharmacies dispensing the wrong drug order; and nurses administering the drug to the wrong patient. While most patients survive these drug errors, some people, like Betsy Lehman, a health writer from Chicago, and Vince Gargano, a postal worker from Chicago, died from incorrect and fatal doses of anti-cancer drugs.
Most hospitals lack systems which could automatically double check individual decisions. Two hospitals in Boston-Massachusetts General and Brigham and Women’s—have just instituted such a system to catch mistakes before patients suffer from the Other hospitals say such systems too expensive.
But Dr. Sidney Wolfe, Director of the Public Citizen’s Heal Research Group, pointed out that “Several billion dollars a year being wasted treating preventable adverse drug reactions.”
Given the extent of injuries a deaths from hospital errors, one must wonder why the American public isn’t more aware of this problem.
Unfortunately, hospitals are not adequately regulated and there is little to no public accountability in America’s health care system. (The #8 Censored story of 1993, “America’s Deadly Doctors,” pointed out how the medical profession fails to report its incompetent physicians.)
Both written and verbal queries about hospitals made to the joint Commission on Accreditation of Health Organizations have gone unanswered, according to Wolfe. “For instance,” Wolfe pointed out, “we don’t have a list of the 40 percent of hospitals who did not pass the test, in terms of quality review over surgery and medicine. But I think the more important point is that this should be a public function. Why is the airline industry, with a much better crash record than hospitals, a public function? Why does the public demand, when a crash occurs or when pilots get licensed, that we look at what’s going on? We don’t have those kinds of data.”
Compounding the problem, in 1995 the Clinton administration quietly killed the formerly required yearly report comparing hospitals’ death rates for Medicare patients, replacing it with less confrontational “systems-oriented” analyses that concentrate on how hospitals generally can perform better. The new reporting requirements do not publicly identify local institutions or their performance, including mortality rates.
SSU Censored Researcher: Nikki Washburn
COMMENTS: Sidney Wolfe, editor of the Health Letter and participant in the ABC “Nightline” program excerpted in the above-cited article, suggested that most of the coverage of this issue was in the form of local examples—the Boston Globe reporter killed by an overdose of cancer drugs; a Tampa hospital cutting off the wrong leg/arthroscoping the wrong knee, etc. “The ‘Nightline’ piece was one of the only, if not the only, national media stories about the causes or solutions to the problem of 80,000 people killed in American hospitals annually.
“The solution to hospital (or doctor-office) errors will not occur as long as the problem is portrayed as specific to certain places. Especially in light of increasing trends of understaffing hospitals, they are once again becoming places where too many people go to die. Hospital trustees (and patients) cannot exercise their ability to improve conditions in their hospitals unless the scope of this problem is known.
Wolfe said that organized medicine and organized hospitals/HMOs are most likely to benefit from the limited coverage; they can simply pretend that this is just a few bad apples and that the basket is mainly okay.
Wolfe also noted that the Health Letter will publish “13,000+ Questionable Doctors,” the fourth version of their report naming those physicians disciplined by federal or state authorities, in early 1996. And, he concluded, “Much more vigilance concerning all doctors and hospitals is needed.”
Thomas Maier, author of the Newsday article, said, “Each year, an estimated 180,000 Americans die from injuries caused in their hospitals—the same place where most people probably think they are safest. Yet as this Newsday story exposed, the only public method of keeping track of death rates in hospitals in the U.S. was quietly killed in 1995. Newsday’s story, which received no attention from the national media, highlighted how the Clinton Admin-istration reneged on its promise to provide consumers with “report cards’ on local hospital performance, and instead dismantled the only federal barometer of that performance.
“Before these yearly reports were eliminated, the results of death rates in local hospitals often drew large headlines in the press. Hospitals, doctors and administrators often objected to the yearly tests-including Clinton’s new appointee to the same agency that wound up killing the studies.
“What happened here is a classic example of how the government lied to the press and no one ever followed up. Yet, the consequences are extremely important to anyone who enters a hospital in this country. With more information about death rates instead of less, patients could make intelligent decisions about where to go when they are sick, and policy-makers could take action to improve hospitals where performance appears to be poor.
“Clearly, the medical community lobbied hard for the elimination of the death rates studies and the creation of a new ‘systems-oriented’ review where the results are never made public. Hospital administrators get a private briefing about the problems found in their institutions. But the public which pays millions for the studies never does.”
Maier also noted that Newsday has worked hard on behalf of the public’s right to know. “Newsday has pushed hard to make government mortality rate studies available to the public,” Maier said. “Three years ago, Newsday won a lawsuit which forced New York state officials to make public its death rate statistics on cardiac bypass surgery.”