MESSAGE FROM ASSOC PROF PAMELA S EVERS ATTORNEY AT LAW This article has been offered by web posting to UNCW students for educational purposes only Articles posted may have been edited for clarity and format by Pamela S Evers PREVENTABLE MEDICAL ERRORS THE SIXTH BIGGEST KILLER IN AMERICA Preventable medical errors kill and seriously injure hundreds of thousands of Americans every year Any discussion of medical negligence that does not involve preventable medical errors ignores this fundamental problem And while some interested parties would prefer to focus on doctors insurance premiums health care costs or alternative compensation systems anything other than the negligence itself reducing medical errors is the best way to address all the related problems Preventing medical errors will lower health care costs reduce doctors insurance premiums and protect the health and well being of patients The Institute of Medicine s IOM seminal study of preventable medical errors estimated as many as 98 000 people die every year at a cost of 29 billion i If the Centers for Disease Control were to include preventable medical errors as a category these conclusions would make it the sixth leading cause of death in America ii Further research has confirmed the extent of medical errors The Institute for Healthcare Improvement estimates there are 15 million incidents of medical harm each year iii HealthGrades the nation s leading healthcare rating organization found that Medicare patients who experienced a patient safety incident had a one in five chance of dying as a result iv Yet despite these numbers the American public remains unaware of just how pervasive the problem is Even though one in three Americans say that they or a family member has experienced a medical error and one in five say that a medical error has caused either themselves or a family member serious health problems or death surveys show that Americans vastly underestimate the extent of medical errors v About half of respondents believe the annual death total from medical errors to be 5 000 or less nearly 20 times lower than the IOM s estimate People have been led to believe that there are hundreds of thousands of medical negligence lawsuits every year and only a handful of genuine medical errors In reality the reverse is true There are very few medical negligence lawsuits and hundreds of thousands dying from preventable medical errors As University of Pennsylvania law professor Tom Baker puts it We have an epidemic of medical malpractice not of malpractice lawsuits vi Much of the discussion surrounding medical negligence revolves around costs whether it be the cost of physicians insurance or the cost to health care While these are the subject of much debate and acrimony the potential savings from the elimination of medical errors are undeniable Dollars better spent on patient safety The Center for Medicare Medicaid Services CMS has in recent years recognized the potential for financial savings by reducing medical errors CMS has stopped paying for hospital and practitioner errors and thus created a financial incentive for hospitals to embrace patient safety After evaluating a number of billable hospital acquired conditions CMS and the CDC decided on eight expensive but reasonably preventable secondary conditions that would not be reimbursed by Medicare and could not be billed to patients vii Previously Medicare rewarded hospital errors with larger reimbursements by paying them an extra amount to treat various preventable complications that developed as a result of hospital negligence The new rules which went into effect in 2008 are expected to save taxpayers at least 21 million annually and will encourage hospitals to take steps to avoid reasonably preventable hospital acquired conditions Private insurers like Blue Cross Blue Shield Association and Aetna have also implemented similar policies not to reimburse medical providers for care related to problems or complications that should not occur in the normal course of hospitalization ix i To Err Is Human Building a Safer Health System Institute of Medicine 1999 ii Deaths Mortality 2005 National Center for Health Care Statistics at the Centers for Disease Control viewed at http www cdc gov nchs fastats deaths htm iii Institute for Healthcare Improvement Campaign FAQs Institute for Healthcare Improvement http www ihi org IHI Programs Campaign Campaign htm TabId 6 iv The Fifth Annual HealthGrades Patient Safety in American Hospitals Study HealthGrades April 2008 v National Survey on Consumers Experiences With Patient Safety and Quality Information Kaiser Family Foundation November 17 2004 Tom Baker The Medical Malpractice Myth 2005 vii Those medical complications not covered were Object Left in Surgery Serious Preventable Event Air Embolism Serious Preventable Event Blood Incompatibility Serious Preventable Event Catheter Associated Urinary Tract Infections Pressure Ulcers Decubitus Ulcers Vascular Catheter Associated Infection Surgical Site Infection Hospital Acquired Injuries including fractures dislocations intracranial injury crushing injury and burns See 72 F R 47201 viii ix 72 F R 47201 Vanessa Fuhrmans Insurers Stop Paying for Care Linked to Errors Wall Street Journal January 15 2008 MEDICAL NEGLIGENCE LAWSUITS FEW AND FAR BETWEEN Although much attention has been given to medical negligence liability crises in reality very few injured patients ever file a medical negligence lawsuit In 2006 researchers at Harvard University announced the results of a study showing that most negligence claims involve medical error and serious injury and concluded portraits of a malpractice system that is stricken with frivolous litigation are overblown i The researchers found that few claims were without merit and those that were generally did not receive any money Most negligence claims were meritorious with 97 percent of claims involving medical injury and 80 percent involving physical injuries resulting in major disability or death Few claims where there was not error were ever paid In fact researchers found the reverse nonpayment of claims where error was involved was a bigger problem Co author William Sage commented These findings are absolutely no surprise to any of us in the policy community They are consistent with everything we suspected and learned from research over last 20 years which is that the major problem out there is medical errors that are not compensated rather than frivolous
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