medical error

When “Never” Happens - Wrong Site Surgery

The Agency for Healthcare Research and Quality (AHRQ) describes “wrong-site, wrong-procedure, wrong-patient errors" as “never events”. Unfortunately, in medicine never does not always mean never. According to a seminal AHRQ supported study, published in 2006, the incidence of wrong site surgery is 1 in 112,994.

In August, CNN reported that the Massachusetts Department of Health was investigating a case where a kidney was removed from the wrong patient at St. Vincent’s Hospital in Worcester, MA. Before a patient gets to the operating room they are typically seen pre-operatively by several members of the surgical team. Each team member acts as a check against wrong-site, wrong-procedure, wrong-patient errors. Ideally, the procedure has been confirmed with the patient multiple times before the patient arrives in the OR - by the surgeon, anesthesiologist and other members of the medical staff. However, the “time-out” procedure in the OR, which entails a verbal confirmation among the surgical team prior to beginning surgery, is the final and official confirmation that the correct procedure is performed on the correct patient at the correct site.  

Unfortunately, the “time-out” is only effective if the medical staff take it seriously and treat it as an opportunity to ensure the safety of their patient. For many medical professionals the “time-out” seems unnecessary - a procedural hurdle that must be completed before the real work begins. Most surgeons can’t fathom the idea of operating on the wrong patient or site. But the case at St. Vincent’s is clear evidence that while rare, these events can happen, if procedures such as the “time-out” are not treated as vital and necessary pre-operative measures.

 

Read more about the case at St. Vincent’s Hospital here: http://www.cnn.com/2016/08/10/health/kidney-removed-from-wrong-patient/

Why Did Lavern's Law Fail?

In June of 2016, the NY State Legislature failed to pass a bill that would have began the window of time a patient has to bring a medical malpractice claim from when an error is discovered by the patient and not when the mistake occurred. The bill was named after Lavern Wilkinson, who died in 2013 from a curable form of lung cancer after doctors failed to notify her of a suspicious mass seen on x-ray until after the cancer had spread. By that time, the 15-month window to bring a negligence claim had expired, leaving Lavern and her family no recourse despite a clear instance of medical malpractice. 

Although Lavern’s Law had previously passed in the NY State Assembly and had the support of NY Governor Andrew Cuomo, it failed to gain support in the legislature. New York is now one of six states without a “date of discovery” law. 

Requiring patients to discover a medical error or misdiagnosis and bring a claim within a 15-month window unreasonably shifts the burden to the aggrieved party, especially when the error or misdiagnosis involves an indolent disease process, such as cancer. In effect, an aggrieved lay person is held to a higher burden of discovering a mistake than the physician entrusted to care for them, a result which seems paradoxical.

Read more about the future of Lavern’s Law here: 

http://www.nydailynews.com/news/politics/cancer-patient-urges-legislature-act-date-discovery-law-article-1.2648631