Medical Errors: How to Protect Yourself

One in three hospitalized patients may fall victim to medical errors or other adverse events—a rate more than ten times higher than previous estimates, according to a new study published this month in Health Affairs. “The more you look for errors, the more you find,” remarked the study’s lead researcher, David C. Classen, who blamed the high rate of errors in part on such factors as sicker patients with more complex medical problems and increased use of medications. 

“Preventable medical errors are the fifth leading cause of death in the US, killing more people each year than motor vehicle accidents, breast cancer and HIV/AIDS combined,” says Sanjaya Kumar, MD, author of Fatal Care and founder of Quantros, Inc., a federally-certified patient safety organization in Milpitas, California. That’s why it’s crucial to understand how medical care can go awry. Here’s a guide to protecting yourself from common medical mishaps.

Medication errors. Up to 80 percent of American adults use OTC or Rx medications or dietary supplements at least once a week. “Medication errors are one of the most prevalent mistakes, especially for patients who are elderly or chronically ill,” says Dr. Kumar. “Keep a list of all drugs and supplements you take regularly in your wallet so this crucial information is handy if you need emergency care, to avoid being given extra doses of a medication you are already taking or a drug that might react adversely with your current medications.” And if you have a drug allergy, consider wearing a medic alert bracelet.

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Infections and superbugs. Hospital-acquired infections kill up to 100,000 Americans a year. “The hospital environment is full of microbes and doctors have a shockingly poor rate of compliance with hand hygiene, with only 56 percent of them washing their hands as recommended,” says Dr. Kumar. One of the best ways to safeguard your health is to carry a bottle of hand sanitizer and ask healthcare providers to use it in your presence. Tell them, “You’ve probably already done this a zillion times today, but I’m worried about drug-resistant superbugs and would feel better if you used the sanitizer before my exam.” Insist that providers wear gloves for IV changes or other invasive procedures. 

Hospital errors. Common preventable problems include falls, bedsores, and delays in care. If you need to be hospitalized, have a relative or friend act as your advocate. For example, Dan Conley noticed that after his mom’s surgery, the pain medication wasn’t working. He repeatedly asked the nurse to check if she was getting the right medication and was assured that everything was fine. As his mom’s agony escalated, he checked the IV himself and discovered that the morphine solution was dripping on the floor—not into his mother’s arm. A friend or relative can monitor if staff is making rounds on time, double check that the right medication is given, and stay alert for problems that may require immediate help.

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Procedural errors. Traditionally, doctors have used “blind” techniques based on anatomical landmarks for needle-based procedures, such as inserting central lines (IVs in the neck). However, the Agency for Healthcare Quality and Research ranks ultrasound guidance for this procedure as one of the most important safety practices to reduce such errors and complications as torn vessels, a punctured lung, and other needle injures. Some top hospitals also use ultrasound visualization to guide needles during regional anesthesia injections and for drainage of fluid from the chest or abdomen, since it’s safer when physicians can see where the needle is going. 

Surgical errors. Mistakes and complications can range from leaving sponges or other items inside the patient to operating on the wrong body part (which is relatively rare). Dr. Kumar advises asking the doctor to mark the surgery site (or doing so yourself). You also want to write “wrong leg” or “NO!” on the incorrect site. Discuss the procedure in detail with your doctor before the operation and get a second opinion from another doctor before agreeing to go under the knife. Also discuss the doctor’s experience: You want a surgeon who performs this operation frequently and tracks his/her complication rate. For more tips on preventing medical errors, visit the Agency for Healthcare Research and Quality’s website.

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