Medical Errors

Some state medical experts say they don't understand why a new federal bill on medical errors - expected to be signed into law within a month - isn't as strong as state law. A bill passed by the U.S. House of Representatives on Wednesday asks hospitals and other health organizations to voluntarily report medical errors to a patient safety organization. The information would be entered into a confidential database so analysts could track and address problems. But in 20 states, including Pennsylvania and New Jersey, reporting health-care mistakes is mandatory and will remain so, leaving some to wonder why the federal bill is less stringent.

Immediately after opening its session for the year, Congress plowed into the problem of medical errors, holding two Senate hearings on the issue last week. On Tuesday, Sen. Arlen Specter (R., Pa.) said he would introduce a bill that could be a prelude to mandating disclosure of medical errors that harm patients. Within two weeks, he said, he would introduce legislation to fund research to help determine the best way to curb the tens of thousands of deaths each year nationwide that stem from medical errors.

Let's say you are a hospital patient who has been harmed by a medical error. Try to imagine your reaction in either of these two scenarios: You and your family think some serious mistake in your treatment has been made and you are desperate to learn more. But doctors and hospital staffers won't tell you what happened. Within days, even hours, of the mistake your physician comes to your room to admit error. Based on what the hospital knows so far, he explains what happened and apologizes.

President Clinton raised the stakes in the developing national debate over how to reduce deaths and injuries from medical mistakes. He announced a series of government initiatives aimed at the problem. On Tuesday, he signed an executive order calling on a White House task force to recommend solutions and to report back within 60 days. He told government agencies that administer health plans for 85 million Americans to take error-reduction measures. "We have the finest health-care system in the world, the best professionals to deliver that care," he said.

If you need to be hospitalized these days, maybe you'd rather be in Philadelphia. A three-year, regional effort to prevent hospital patients from being harmed by medication errors is producing significant results at 49 area hospitals. On both city and suburban hospital wards, doctors, nurses and staff are taking steps that could reduce the mistakes that injure and kill patients. That means implementing more careful methods for ordering patient medications, expanding safety training, and promoting a more open climate for reporting errors.

Amid growing awareness that medical errors are a problem not just for adult patients, a federal agency has compiled a list of suggestions on how parents can protect their children from mistakes both in the hospital and in the doctor's office. "Very young children can't speak for themselves, so they need someone to be monitoring what's happening to them," said Dr. Carolyn Clancy, acting director of the Agency for Healthcare Research and Quality. "Parents need to be an active part of their child's health-care team.

WASHINGTON - The Obama administration announced a broad new initiative Tuesday to reduce medical errors, partnering with private insurers, business leaders, hospitals, and patient advocates to tackle a problem that kills thousands of Americans every year. The campaign, funded by the health-care overhaul the president signed last year, aims to cut the number of harmful preventable conditions such as infections that patients acquire in the hospital by 40 percent over the next three years.

If a jumbo jet dropped out of the sky every other day, you can bet all your frequent-flier miles that the nation's leaders would leap into action with a plan to safeguard air travelers. So what's taken Washington policymakers so long to deal with a problem that contributes to as many as 98,000 deaths nationally each year? The problem is medical errors. The scale of the problem has been known at least since 1999, when a landmark Institute of Medicine study cited that number as the upper range of how many people are killed by medical errors annually.

Since the release of the National Institute of Medicine report "To Err is Human: Building a Safer Health Care System," there has been a great deal of local and national media coverage about medical errors. As the report indicates, America's health-care providers and hospitals are the best in the world. But as with any system that relies on human beings, our health-care institutions are not infallible. In some cases, errors occur, and sometimes the consequences are tragic. Any error is one too many.

President Clinton is expected to sign an executive order today directing a task force to find new strategies to reduce medical errors and to instruct government agencies to evaluate and implement error-reduction techniques. White House officials said Clinton would announce the measures in the Rose Garden after a planned morning meeting with representatives of health-care providers, consumers, purchasers, lawmakers, and the Institute of Medicine. "The President believes we should move quickly in this area and is unveiling a series of initiatives to reduce medical error and improve patient safety," said Christopher C. Jennings, deputy assistant to the President for health policy.

HARRISBURG - A panel credited with reducing medical errors at Pennsylvania hospitals says its own health is endangered - by Gov. Corbett's plan to fold it into the state Department of Health. The board of the Patient Safety Authority adopted a resolution Tuesday saying such a move would destroy its autonomy. The privately funded authority, which collects and studies hospital data, has gained a national reputation for improving patient safety. "We felt strongly we should resist this movement," said the authority's acting chairman, Stanton Smullens, chief medical officer at Jefferson Health System in Philadelphia.

Emily Jerry was just 2 years old when she died from a medication error made by a pharmacy technician in a Cleveland hospital. She had undergone surgeries and four rounds of chemotherapy to treat what doctors said was a highly curable malignant tumor at the base of her spine. Emily's past treatments had been so successful that her last MRI showed the tumor had miraculously disappeared, her parents say. This last treatment on her second birthday was just to be sure that no traces of cancer were left inside her. Tragically, the technician mixed her final dose of chemotherapy improperly, in a saline solution that was 23 times more concentrated than it should have been.

Medical errors kill A new study by the New England Journal of Medicine has found most medical malpractice claims submitted by patients to doctors' insurance companies are dropped without payment ("1 in 5 malpractice cases leads to a payout," Aug. 18). This confirms what we have known in Pennsylvania for some time: Insurance companies continue to gouge doctors with ever-increasing premium rates even as they report record profits and reduce payouts. This study does not evaluate the merit of the claims that are dropped.

WASHINGTON - The Obama administration announced a broad new initiative Tuesday to reduce medical errors, partnering with private insurers, business leaders, hospitals, and patient advocates to tackle a problem that kills thousands of Americans every year. The campaign, funded by the health-care overhaul the president signed last year, aims to cut the number of harmful preventable conditions such as infections that patients acquire in the hospital by 40 percent over the next three years.

Republican leaders are still talking about writing an epitaph for the sweeping reform of health care in America. That takes a lot of gall, given all the positive reviews coming in this week for the first major consumer benefits provided under the federal overhaul. President Obama pointed out Wednesday that implementation of the plan's patients' rights provisions "will end the worst insurance company abuses and help put consumers in control of their own care. " But Republicans in Congress - hopeful of taking back the House in November - are ignoring that and instead talking about cutting off funding needed to enact the Affordable Care Act, signed by the president six months ago. They want to repeal key provisions designed to make health insurance affordable and available to nearly 33 million uninsured Americans.

In 2009, the number of new medical-malpractice lawsuits filed in Pennsylvania courts fell for the fifth straight year, according to a report released Tuesday by Pennsylvania Chief Justice Ronald D. Castille. The report provides new evidence that the malpractice climate in Pennsylvania has cooled since the early part of the decade, when rising costs led many doctors and hospital administrators to worry that the state's medical system might collapse. Philadelphia - long considered the center of the state's malpractice crisis because of the large number of generous verdicts here - saw the most dramatic declines in new suits and in large jury awards, as well as a rise in defense verdicts.

The health-care debate has been marred by the distortions, demagoguery, and outright lies that are typical of modern American political discourse. For example, lacking any substantive ideas of their own, reform opponents have seized on tort reform - taking away the rights of injured patients - as their solution to America's health-care problems, despite ample evidence that it's no solution at all. Let's call this tort-reform fixation what it is: a sign that many Republicans are bereft of ideas and obsessed with an issue that will do nothing to lower care costs or cover the uninsured.

The 2009 New Jersey Hospital Performance Report issued yesterday examines how well the state's 72 general hospitals met widely accepted care standards in four areas and for the first time details hospital-by-hospital rates of 12 preventable medical errors. Overall, two area hospitals, Our Lady of Lourdes Medical Center in Camden and Virtua-West Jersey Hospital - Voorhees, scored in the top half of hospitals in the four areas - treating heart attacks, pneumonia, and heart failure, as well as surgical care.

It's a rare August, indeed, when health-care policy white papers vie with beach reading lists, and Post-it notes scrawled with "attend town meeting" festoon fridges stocked with cold ones. But the surprising, if painstaking, progress being made in Congress toward crafting a measure to overhaul their health-care system has given Americans some heavy homework to do. With Washington cleared out, the debate on health-care reform now goes intensely local. In meetings and discussions with constituents, House and Senate members will be testing the ideas that have emerged so far from several congressional committees - and those yet to be crafted by a key Senate panel.

James Armstrong had no way to know that his prostate-cancer treatment had gone dangerously awry as he recovered from the brief procedure at the Philadelphia VA Medical Center in August 2007. Doctors for the Vietnam War veteran from West Philadelphia, however, should have known, federal investigators concluded. The dozens of tiny radioactive seeds they had implanted in Armstrong's prostate gland were delivering only about a quarter of the radiation called for in his treatment plan - too little by established standards to wipe out his cancer.