A recently carried out study of Johns Hopkins claims that medical errors cause the death of more than 250,000 people in a single year. Some studies even claim that that death caused by medical errors are even more than 250,000. According to Johns Hopkins data, medical errors count as the third leading cause of death in the USA. Only two diseases that are more deadly than medical errors include heart diseases and cancer. There is much improvisation in data of causes of death; the doctors and other staff associated with them usually don't mention the mistake of a physician surgeon or inadequacy of the medical apparatus as a cause of death. The other causes of death mentioned on the patient's death certificate are taken as truth by the Centre for Disease Control and Prevention. The same statistical data is passed on in the record registers.
The death caused by a medical error lies on the system's shoulders and administrative authorities. Qualified medical professionals are usually dedicated and hard-working. Hence, the responsibility goes to the system more than that to an individual medical professional. The usual causes of the medical errors include an inadequate number of health and medical professionals, old or defective medical instruments, errors in the judgment of the patient's condition. Though there are some conditions in which physicians or pharmacists make mistakes, they can misdiagnose a patient due to lack of knowledge or properly adjust the drug's dose. The common medical errors, the causes of those medical errors, and the measurements to eliminate those medical errors are discussed in detail. (1)
Common Medical Errors
Many medical errors occur in the hospital setting. However, some errors are more common as compared to other errors. Complete detail of all the common medical errors is given below.
When a patient has some serious illness, the error of diagnosis can prove deadly. In such serious conditions, there is an immediate need to start the right therapy for the disease. But if the physician makes a wrong diagnosis, the immediately required medical therapy will be replaced by an inappropriate therapy. Sometimes, inappropriate diagnosis and inappropriate therapy can even worsen the symptoms of the existing medical condition. Some treatments have severe outcomes, so they are given only under conditions when no other medical treatment is available for a given disease. Suppose a physician comes up with such diagnosis and treatment even without that disease and starts that treatment. In that case, the patient will suffer severely from those severe side effects without reason.
Delayed Diagnosis is another medical error that is common in healthcare. Sometimes, the symptoms are not as severe as the underlying cause. In such cases, the physician may ignore the symptoms at the initial stages, which leads to a delayed diagnosis. When a diagnosis of some severe disorder is made, the symptoms may already be beyond the physician's hands. This way, delayed diagnosis can become a cause of the death of a patient.
Error of Medication
The error in the choice of medication or dosage of medication is one of the most commonly encountered medical problems. The error can be a mistake of the physician or pharmacist. The physician may enter the wrong medication or dosage of medication in the prescription. The pharmacist may also misread the prescription and give some other medicine or incorrect medication dosage. In case of wrong medicine, the drug may worsen the patient's condition instead of improving it. The dosage of the medications is also highly selective according to the gender, age, ethnicity, and overall health of the patient. A slight chance of dose may make a drug many times less or more potent. If a low potency drug is given, the drug's therapeutic effect may not be produced, leading to the patient's death. On the other end, some drugs have life-threatening side effects above their therapeutic dosage. In short, the error of medication can lead to the patient irrespective of its cause.
Incorrect Results Produced by Medical Equipment
There are many types of equipment that are used in medical labs. The can be a mistake in the lab reports produced by this equipment. The incorrect result can be due to some mistake in the lab procedure or due to a problem in the manufacture of the equipment. These incorrect lab reports mislead the physician, who ultimately harms the patients.
Transfer of infections to the Patient
All the medical and surgical procedures are directed to be carried out following a protocol that minimizes the risk of transferring the infections to the patient. Sometimes, there is negligence in sterilizing the surgical instruments and sanitization of the hands, beds, or flood of the wards, which leaves the patients at risk of getting infected. There are many bacteria and viruses, which infect people, mostly in healthcare settings. Examples of common hospital-acquired infections nowadays include infections of MRSA and COVID-19.
Mistake in Checking the Apparatus Before Surgery
It is necessary to check all the accessories before starting surgery. Suppose you forget to take some important tool to the operation theater before starting a surgical procedure. In that case, it may cause inconvenience and may prolong the duration of the surgery. This delay may cause extensive blood loss or some other complication. The prolonged surgery also increases the risk of transfer of infection to the patient. (2)
Improper Use of Medical Devices
Every medical device needs to be used at an appropriate time in an appropriate method. The mistake in the use of surgical appliances causes severe complications. The prosthetic heart valves may not be implanted that can lead to the death of the patient. Similarly, if the lab machines are not operated according to suggested methods, you will get incorrect lab reports.
Mixing of Samples
Mixing of samples is a common medical error that we encounter. The mixing of the samples will result in the misdiagnosis of both patients. The medicines or further treatments based on mixed-up samples' results can lead to life-threatening mistakes in the further treatment.
Leaving some surgical Instrument in body cavities
Though it is a rare medical error, it lies in the category of criminal negligence. The surgeon may not be paying full attention to the surgery or stress of work Overload can also lead to this error. The surgeon’s team members should be vigilant to prevent such errors.
Causes of the Medical Errors
There are many causes of medical errors. The causes can be international, unintentional, evitable, or inevitable. Some of the major causes of the medical errors have been described in the following section.
Lack of Knowledge or Training
One of the common causes of medical errors in untrained physicians, pharmacists, and lab technicians. The problem occurs when they try to do something beyond their knowledge. The lack of training or knowledge can be due to the professor's mistake or the head of any department who has the duty of teaching and training the healthcare workers who work under him. This lack of knowledge and training may lead to a misdiagnosis, late diagnosis, wrong choice of medication, and inadequate surgical procedure putting the patient's life at stake.
Lack of Communication
Lack of communication between different segments of healthcare is one of the most common causes of medical errors. Poor communication between doctors, pharmacists, nurses, and other paramedical staff may lead to inappropriate medication use. The results of this lack of communication are disastrous.
Negligence of the Healthcare Workers
Most of the health care professionals are dedicated and hard-working. However, some of them can be negligent. There can be negligence in writing a prescription, reading a prescription, and performing a surgical or lab procedure. Such negligence can lead to misdiagnosis, ADRs of medication, and complications of surgical procedures.
Sometimes the inappropriate attitude of the patient can also lead to medical errors. The incorrect history given by the patient can lead to misdiagnosis. Some patients do not allow certain procedures due to religious or cultural reasons; this can lead to the progression of the disease before starting the treatment. The insufficient education of the patient is one of the main reasons for creating problems in doctor-, patient relationship.
Work Overload or Lack of the Staff
Work Overload is one of the main reasons for medical errors. Suppose a physician has to check more patients in an hour. In that case, he can not give every patient the required time, leading to misdiagnosis or wrong prescription. Similarly, a lab technician may mistake in carrying out tests if he has to perform the tests more than his capacity. A pharmacist may make a mistake in reading the prescription in a hurry. He may give the wrong medication or the wrong dose of the correct medication. There can be a mixing of samples, prescriptions in conditions of work Overload.
Many diagnostic tests are done with machines such as PCR, X-ray, USG. If there is a fault in these machines, it can produce misleading information. The ultimate result would be the inappropriate treatment which can be deadly for the patient. Similarly, if there is some fault in grafts or implants, it can cause life-threatening complications.
Complex Picture of the presenting Complaints
In some cases, medical errors are inevitable. In many cases, patients present in the hospitals with complex symptoms, their lab reports also present a complex picture. It becomes hard for a physician to make a diagnosis and make a treatment plan in such cases. The responsibility of medical errors in such cases usually doesn’t lie on the physician.
Inadequate Health Policies
The administration and government formulate healthcare policies. Inadequate health policies may be hard to apply on the ground in hospital settings. If these policies are not coherent with the workload, resources, and workforce, the results can be disastrous. The ultimate suffering will go in the hands of the patients. (3)
How to Reduce Medical Errors
The tough job is to track the causes of the medical errors. Once we identify the causes of the medical errors, we can make appropriate strategies to prevent the medical errors. Some common ways to reduce medical errors are given below.
Improving Communication Between Different Segments of Healthcare
As we discussed above, lack of communication is one of the leading causes of medical errors. Frequent communication between physicians, pharmacists, nurses, and lab technicians is a key to lower the risk of medical errors. They can confirm with each other about lab reports, prescriptions, and medicines if they have better communication. This reassurance will significantly reduce the occurrence of medical errors.
Appropriate Training of the Junior Staff
The senior members of every department have to teach and train the Junior staff. If they have adequate knowledge and training, the case of misdiagnosis and faulty procedures will be significantly reduced.
Involving the patient
Involvement of the patient in a discussion about his ailment and treatment methods creates a trustful doctor-patient relationship. This patient will be able to provide better history and won’t resist the performance of different procedures. Provide all the necessary information to the patient; this way, the medical errors occurring due to lack of patient communication, will be significantly reduced.
Role of Pharmacists and Lab Technicians in Reducing Medical Errors
Pharmacists should be in touch with the physician. They should be cautious about the drugs that have names that sound alike; they should also be careful about the drugs with similar packaging. They should also try the use of bar codes of drugs to reduce the mix-up of drugs. Lab technicians should also adopt the above-described behavior to prevent medical errors.
Regular Monitoring of the Medical Equipment
There should be regular monitoring of the appropriate functioning of the medical equipment by the experts. This way, we can significantly reduce the errors of medical reports and thereby improve the different choices of medical and surgical procedures.
Other Common Ways to Reduce Medical Errors
Besides the above-described methods to prevent medical errors, the surgeon or physician should ensure that he has got everything required for the procedure. Surgeons should be especially cautious about this aspect. The physicians and surgeons can be accused of civil or criminal negligence if they do not pay full attention to the patient while carrying out any procedure.
The Govt. Should also make sure that their health policies are practically applicable. Besides this, they should make sure the even distribution of doctors and other health workers reduces the work Overload. They should also facilitate the patients in hospitals and provide up-to-date medical equipment. At the end of the day, it’s the government or system of the government that can bring change in collaboration with the individual efforts of the health care workers. (4)
Medico-Legal Aspect of the Medical Errors
Suppose someone thinks that his physician, surgeon, or other healthcare staff is responsible for his impairment. In that case, he can consult the court in this regard. The court further decides the penalty for the harm caused by the healthcare worker to the patient.
In case of civil negligence, the healthcare worker will pay the amount of money specified by the court to the patient. If there is a combined mistake of different healthcare workers like doctors, Pharmacists, nurses, the specified fine will be distributed accordingly. If the medical error occurred due to a combined mistake of the healthcare worker and the patient, the responsibility of the healthcare worker will be reduced according to the mistake of the patient.
In case of criminal negligence, the court may cancel the license of a health care worker. Depending on the type of criminal negligence, the healthcare worker can be prisoned for years and the payment of the money. An example of criminal negligence is that a surgeon over anesthetizes the patient for personal joy and satisfaction. (5)
This article covers all the aspects of medical errors. Medical errors are the third leading cause of death after heart diseases and cancer in the USA. The data provided to the authorities is improvised so that to hide the maximum number of deaths occurring due to medical errors. There are various reasons for medical errors. These major reasons include lack of communication among the healthcare workers, inadequate knowledge and training, lack of information among the patients, and faulty equipment. The common medical errors that occur frequently include misdiagnosis, delayed diagnosis, medication error, transfer of the infections to the patients, and mixing of the samples. We can take some steps can be taken to reduce medical errors. These steps include improving the communication among the healthcare workers, improving the communication with the patient, reducing the workload on the healthcare workers, and keeping the medical apparatus sterilized and up to date. Medical errors may drive a health care worker to court if the patient complains against him. The medical errors are dealt with in court according to the severity of the case. The court specifies a certain penalty in favor of the patient if the doctor is found guilty.
Roel E, García-Díez M, Borrás Bermejo B. Errores médicos, ¿la tercera causa de muerte en Estados Unidos? [Medical errors, the third leading cause of death in the United States?]. J Healthc Qual Res. 2019;34(6):339-341. doi:10.1016/j.jhqr.2019.06.005
Weeks J. Integrative Health: Implications from a Report That Medical Errors Are the USA's Third Leading Cause of Death. J Altern Complement Med. 2016;22(7):493-495. doi:10.1089/acm.2016.29006.jjw
Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139. Published 2016 May 3. doi:10.1136/bmj.i2139
Rodziewicz TL, Houseman B, Hipskind JE. Medical Error Reduction and Prevention. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 4, 2021.