07 April 2008

Medical Mishaps Still A Problem

The bad news is that the 7.3% medical mishap rate for children (including a roughly 1.5% preventable mishap rate which is close to the definition of malpractice) in hospitals is (1) based upon specialized children's hospitals, not all hospitals where children go, and (2) includes only medicine related problems, not all problems that can crop up in a hospital setting. For example, it excludes the common problems like infections acquired in the hospital (which are often antibiotic resistant) and bedsores arising from insufficient nursing attention.

The good news is that it puts the lie to the implicit argument of tort reformers that a sensible alternative to the current system is the current system with smaller damage awards in meritorious cases. While the tort system is no panacea, medical mistakes are a common and serious problem. It also identifies a major, but managable problem -- mishaps involving children prescriped narcotic pain killers. When we know that a specific problem exists and is one of the dominant problems faced in a hospital setting, it is easier to solve it.

Medicine mixups, accidental overdoses and bad drug reactions harm roughly one out of every 15 hospitalized children . . . Researchers found a rate of 11 drug-related harmful events for every 100 hospitalized children. That compares with an earlier estimate of two per 100 hospitalized children, based on traditional detection methods. The rate reflects the fact that some children experienced more than one drug-treatment mistake. The new estimate translates to 7.3 percent of hospitalized children . . . .

The study is being released today in the April issue of the journal Pediatrics. It involved a review of randomly selected medical charts for 960 children treated at 12 freestanding children's hospitals nationwide in 2002. . . .

More than half the problems the study found were related to these powerful painkillers, including overdoses and allergic reactions. Although 22 percent of the problems were considered preventable, most were relatively mild. None was fatal or caused permanent damage, but some "did have the potential to cause some significant harm[.]"

Earlier studies relied only on nonspecific patient chart reviews and voluntary error reporting and produced a problem rate of less than 4%. This study, instead, looked not only for expressly reported drug problems, but also for the use of medical procedures and symptoms specific to drug problems.

No comments: