How to Avoid Surgical Mistakes
Medication
errors like the massive overdose of heparin given to Dennis Quaid’s
newborn twins have received a lot of attention, however the National Patient Safety Benchmarking Center found that surgical errors are the most costly and frequent types of medical
errors occurring in hospitals today. A few years ago comedian Dana
Carvey had a coronary artery bypass operation where the wrong vessel was
bypassed later requiring a repeat operation.
With an increasing shift of surgical procedures away from hospitals, and
the difficulty of assessing the number of procedures performed for the wrong
diagnosis or poorly performed procedures requiring further surgeries, the
true costs both in dollars and suffering are difficult to grasp. Although our medical care system has made
unprecedented advances and helps more people than ever before, it is easy to
understand why the prospect of having a medical procedure can create a lot of
anxiety and worry. Here are a few
tips to help you avoid becoming the victim of a surgical error:
- Confirm the right Diagnosis: If you have any reservation or
concern regarding the diagnosis or plan of treatment get a second or
third opinion from an independent physician.
Medicine is complex and your physician
has to first be a detective. Frequently
both the patient and physician are afraid to ask: What else could it be? In an upcoming article in Arthroscopy, we
describe a new minimally invasive technique to address a pinched nerve in the
shoulder; the patients in the study each had multiple previously failed
operations for their shoulder pain. The
diagnosis of a pinched nerve had not been previously considered.
- Check out your doctor and
facility: I recommend finding a
surgeon that performs at least 50 of the specific procedure you are
considering per year- meaning on average the surgeon is performing the
procedure on a weekly basis. Ask
your doctor how many of the specific procedures he does annually. Like a professional car racing team having
a team and facility that performs the specific procedure you are
considering repeatedly is the best way to reduce your chances of a
complication.
The success rates and complication rates reported in the
medical journals are done by teams that often only perform that procedure. However, most shoulder replacements are
done by surgeons who perform ten or fewer of these procedures per year. When Consumer Reports surveyed 1,001 patients
having hip or knee replacement at a variety of facilities, they found a 5%
infection rate. This is more than five
times higher than reported in several major studies. For all but the rarest of procedures, both
Consumer Reports Data regarding the rate of complications including infections
is not readily available to the public for all procedures so ask your surgeon
and facility for a rate for the specific procedure directly. Because the rates of infections and
complications vary so greatly there is some resistance to complete disclosure
of this information. Some sources for
more information: www.hospitalcompare.hhs.gov
(Medicare Website) http://www.stophospitalinfections.org/learn.html
(Consumers Union ) www.medicalconsumers.org
- Take charge of your care: Trust but verify. Even though the surgical team may do
hundreds or thousands of a particular procedure, this is the only one that
is important to you. Make sure
everyone you come in contact with someone who knows who you are and why
you’re having surgery. Make sure
you see your surgeon and confirm the surgery site before the
procedure. The American Academy of
Orthopaedic Surgeons encourages all its members to sign the
surgical site before surgery. A
recent article from The New England Journal of Medicine found that a
checklist similar to the preflight checklist pilots use makes sure everyone
on the team is on the same page, and this reduces the risk of
complications.
Vivek Agrawal, MD,
Orthopaedic Surgeon and Medical Director of The Shoulder Center. www.TheShoulderCenter.com
For interviews please contact Steve Keyser at steve4pr@gmail.com or
call 415-686-0668