Preventable Medical Errors and How We Count Them

[@arthurobrien7424]

The future colleague thing sounds weird stylistically, but I dig the full transperancy.

[@Sporkredfox]

I concur, it sounded strange. My brain did a double take when he said that. Took me a second that he was saying it for transparency.

[@Holly-days]

Sounded to me like those students were pretty astute!

[@sheslostcontrol24]

Thank you again HT crew.

[@srijanatimalsina2799]

" Sick patients are likely to have more medical interventions and therefore more opportunities to have a preventable error occur." " Vast majority of preventable medical errors don't result in death; they result in other harm which are probably more pervasive and might have a bigger overall impact." I do support you concept. Even though all the preventable medical errors are not completely measurable but the healthcare staffs and hospital should take extra measure to prevent errors and provide preventive and promotive care to patients.

[@theyxaj]

I love how these videos have content from the very start of the video!

[@garrettkajmowicz]

As someone who has committed a medical error, I am very thankful that not all medical errors result in death.

[@meganschmidt3235]

Headlines such as the one mentioned in the video about "Hospitals killing more people than guns" flood the media now a days. It makes people scared and nerved to go to hospitals anymore. This video did an excellent job of providing counter arguments using other studies performed. As a healthcare professional I understand the importance of deaths caused by the hospital but also believe like the video states they're many problems with the way the statistics are calculated. a good point was made that sicker people are getting more medical interventions and treatments therefore have a greater chance of experiencing an error. This is true as in some drugs the difference between .1 and .2 makes a huge difference. It is harder to walk into a room to administer 10-15 drugs rather than to walk into a room with only 1-5 drugs. When you look at it nurses and other healthcare professionals are only human. We are bound to make mistakes sometime in our life. The only difference is the mistakes made in a healthcare setting may have a far greater impact than a mistake made by a teacher or accountant. Another good point that I hadn't given much thought to was the fact of who are the patients dying at the hands of the hospital. when you hear that number I believe that many people's minds jump to young children or young adults who shouldn't be dying from going to a hospital. The studies have shown however that this is not the case and that many of the patients dying are geriatric patients who would not have much longer to live. I understand that it is important to recognize that all deaths are sad and tragic but when looking at the statistics I believe this is one important part they are failing to present. All in all i Believe it is important to realize studies such as these to try and make healthcare professionals more aware and careful when doing their jobs but the information needs to be presented correctly.

[@macgirl1234]

this was a really good video! thanks for helping to dissect the evidence :D

[@khrdmn2793]

It couldn't be more true to say that any headline that gives people something to be angry about, particularly when they can blame the system, catches the public eye. News stories can take any aspect of a "study" that they think will potentially be controversial, and spin specific details so that the audience they are appealing to takes only the facts that are presented to them as innately true, failing to ask any further questions. It is actually an incredibly sad thing that so much of healthcare has become about blaming the provider; to the point that a professional cannot always enact what they think is actually the best treatment for their patients due to the fear of lawsuits. Remember that journalists are not researchers, and interpretation of results from studies is much more complex than it seems when buried within an impressive headline.

[@natashamccoy9035]

Healthcare professionals are put in the position to save someone’s life. They go through training and practices so that they know when to use the proper steps to treat a patient. I know that mistakes happen and sometimes the wrong dose or even the wrong medication maybe given and things go wrong but there are also other nurses and doctors that can help to make a better decision. When things like this happen I don’t feel that anyone is blaming the provider for no reason at all. Doctors and nurses should know what treatments are the best ones to give.

[@stfdffalex1841]

This video raises several powerful points regarding errors in the medical community, and further, how difficult reliable research is in such a field. For starters, the numbers are big, however so are the numbers of people that visit a hospital on a daily, monthly, and annual basis. The emergency department at the hospital I work in sees over 95k patients annually. That's just and ER, in a relatively small town. A lot of people routinely visit their doctor's and hospitals, and the real hope, is that these numbers do not deter people, but rather, they seek to understand how the research generates its data. This can be a daunting and unreasonable task for the general public as outside of the science community, there is little, to no understanding of research methodology. Saying that preventable medical errors account for one third of the deaths in hospitalized patients is a big claim by these researchers; and as Dr. Carroll continues on to say, there are multiple reasons the numbers appear the way they do. Not only is their actual cause of death very difficult to pinpoint in the first place, each patient has a different list of risk factors prior to being cared for in a hospitalized setting. Given this, he makes it very clear that there is a difference between correlation and causation. Anyone who has done scientific research should know this, because it is beaten into our heads. He also reiterates that the research teams demonstrate this struggle as well discussing how a team of experts has a very low rate of agreeing on the difference of correlation or causation on a patient-to-patient basis. I myself have an easier time wrapping my head around the numbers that half of one percent of the patients with deaths caused from preventable errors had a chance of living three months longer in good health, even with optimal care. Unfortunately we do not know how 'optimal' was operationally defined, however we do know that everyone in the medical field is a human, and humans are not perfect, and even doctors and nurses, are not always optimal. Overall I very much enjoyed the video, and the way that the facts were presented!

[@ethanw2450]

You've been a doctor as long as I've been alive

[@malloryhestwood5220]

Patients and society mostly blame hospitals for the death and medical errors regarding patients. Although hospitals do make mistakes, as described in the video, I believe the people are the ones that make the mistake that could have been prevented. I liked how this video really touched upon the people's power that they have. People don't always understand what they are getting themselves into when they enter the hospital to seek treatment for a condition or situation. They expose themselves, like the video says, to several different people, all whom may be carrying a disease or some kind of illness. Doctors and hospitals are not to blame for that. Also, more than likely after a surgery or procedure, the doctor gives specific instructions of the post-operation of steps they must follow in order to get better. My father is a dentist and he runs into this problem too many times. He will explain to the patient what must be done, makes sure they understand, and then proceeds to even write down all that they need to know, yet the same patient will be in within the next couple days complaining of pain. Nine times out of ten, it is due to the lack of listening to the doctor's instructions. I am not saying that hospitals don't ever make a mistake they can prevent, but patients more than likely put themselves in situations where illness and error is highly possible.

[@Holly-days]

Good topic, good video, and interesting comments. Firstly, for those who are now scared to go to a hospital when/if it becomes needed (as someone commented), I advise anyone anticipating any serious medical care, surgery or or treatment, bring a trusted friend or relative with you. You'll be anxious which will potentially cause you to miss some of the explanations you need to make decisions for yourself. Second, take the time to be sure to get all your questions answered. Third, realize that what you heard here are estimates based on assumptions, not necessarily accurate data that would differentiate correlation from causation. Also, other factors leading to mortality must be considered as discussed in the video. There are way too many variables to take into account to assume the stats are so ominous as at first it sounds. One trouble is once a huge disturbing, often exaggerated, and/or misunderstood statistic is "out there" it is very difficult to work it back and dispel the concerns. (E.g. the popular belief that vaccines cause autism, that won't go away no matter how many studies prove no link.)

[@meganmcmichael7527]

I think that all of the points you brought up address many of the concerns that a lot of previous commenters, and probably other people, have as well. It's very important to make sure you get all of your questions answered no matter what kind of procedure or treatment you are getting done. The video did an excellent job touching on the fact that there are probably other causes for the deaths in certain figures that were presented and I'm glad you brought that up. The human body is this crazy, amazing thing and often times it truly is difficult to pinpoint one certain cause of death when quite honestly it could be a combination of several things.

[@DanielFoland]

Great show as always.

[@sjcwoor]

Hey Aaron. Here's a weird question. When I'm drunk as hell, why do I feel less drunk and able to drink more, without ill effects when I consume a tonne of candy?

[@amberscott4024]

My father in law's death was contributed, at least in part, to preventable medical error. His prognosis was good and he was expected to come out of a coma within a week. The hospital did not, however, think to keep a 400 lb man with a history of smoking, cocaine use, and multiple heart medications on a blood thinner. They took no measures to prevent a blood clot despite him being at the highest risk. In the end it was DVT breaking and off and travelling to his lungs that killed him. There is no saying whether or not he would developed the clot even with preventative measures. But there was enough to come to an agreement that we wouldn't see a bill and they wouldn't be sued.

[@TheInstituteOfArtAndIdeas]

Find out more solutions to medical error from psychiatrists David Nutt and David Healy, Clare Gerada, the former Chair of the Council of the Royal College of General Practitioners in the UK, Labour MP Diane Abbott, former Health Minister Gisela Stuart, Director of ResPublica Phillip Blond and others, and let us know what you think! kzbin.info/www/bejne/n4a6iHZudsaDsNk

[@leahbuonodono5025]

Hearing such large numbers such as the ones in this video are likely to scare people from going to the hospital. It is extremely hard to distinguish the line between an unpreventable death and a death from medical error most of the time. When someone dies from a car crash it is pretty easy to tell if they died from the impact of the air bag, from not wearing a seat belt, or being crushed. When it comes to medical errors it can be very hard to distinguish weather a person’s death could be avoided. This should not turn people away from hospitals. It is very rare that a person dies from coming into the hospital. It is much more common for a person to die because they decided not to seek medical attention when they really needed it. You do need to always take percussions when going to the hospital because there are many different types of bacteria that you are exposing yourself to. Do not let this turn you away from going to the hospital, be aware of your surroundings and don’t be afraid to ask your doctors and nurses if they have washed their hands. The hospital isn’t a place you should fear. It is a place of healing.

[@zisisstip49]

Is it a reason for hospital suing? CDC admits they don't know the role of fecal dust in environment contamination in hospitals, from poop residue, following wiping. This means it could play. Hospitals don't apply any measure to prevent that residue coming out from toilet and going into the ward. A patient who catches up a HAI, could sue the hospital for neglect? Isn't it a case of preventable medical error?

[@stefanielorimer]

I question their intent and acumen. I also question their motives. This is done to teachers all the time. The fact that Fred and Susie can't read may have to do with their teacher being crap but it may have to do with a HOST of other factors far beyond anything the teacher can influence.

[@BiteSizeRandom]

okay, but how do you explain a death rate drop of 10% when doctors are on strike, this is something that is observed throughout the world, I myself observed multiple mistakes done by physicians , I think the estimate of the researches is correct if not understanding the problem , it may not cause death at any encounter but it's definitely an existing problematic issue. My Hope Is that in the future we can computerized most of the diagnosis so we can have less human errors

[@skphil2053]

It goes without saying medical errors do happen, and like Alexandra Davis said, these errors definitely need to be addressed. The fact is, there are many factors that play into making these errors. Now while the numbers are high, (251,454 hospitalized patients deaths from medical error in 2013 an “under estimate” of the actual amount of errors) just like the video, I find it hard to believe that medical errors account for one third of or 10% of the deaths in hospitals. For instance the example used in the video of the 86-year-old with advanced dementia and serious cancer who was prescribed a drug in a slightly-too- high dose a few week prior to passing away. Yes she was given a slightly-too-high of a dose, but there were other factors that might have caused her death. If her case was looked at in the three-month prognosis I doubt that she would have fallen into the half of the one percent who would have live 3 month more in good health when taking her age and condition into consideration. Along with this I think that the video makes a good point when saying that the potential harms of hospital and doctor’s offices have to be compared to the benefits. There are risks wherever someone goes. Attending hospitals and doctor’s office holds a higher risk because they are exposing themselves to other sick patients. These statistics, while alarming, should not prevent you from trusting a physician. While there are instances where medical errors are made, the benefits of seeing a health care professional strongly out weigh the risks. The video states that only 6% of the deaths were probably preventable. Since they used the word probably, it is more likely that less than the 6% were avoidable. While this video shows there are issues in the medical field that need to be fixed, the actually chance of running into one of these problems is relatively low.

[@gabrielhuber106]

I think it's much more important to focus on the harms caused by alternative medicine. When I was a small child and had a bad infection, my mom often took me to homeopaths. They made me take sugar pills instead of properly treating it.

[@shanicecooper9516]

I believe that medical errors can have an impact on someone's death but not necessary all the time. Patients having previous health condition/sickness is something that I would consider to be a part of some patient's death, if it was before the medical error. However, that doesn't mean that physicians shouldn't take medical errors serious because making too many medical errors in the hospital can cause serious trouble with the patient and law enforcement.

[@guillaumebourgault5532]

You need a good grip on reality to be able to do anything of value. Exaggerated claims in the long run will not help anybody, they amount to crying wolf when it's not warranted.

[@caseyblundell3722]

I agree that there may be medical errors made in healthcare setting more often than there should be, but are these studies and statistics really accurate? These claims suggest that medical errors are killing more people than guns and that just seems unreasonable. Many of the patients who die are actually very sick, but even with a medical error being made in a situation like a code in a hospital, where things are moving very rapidly because a person’s life is on the line, many of the high severity patients that claim to have a medical error as their cause of death were expected to die from their condition anyways. I really like the example he used in the video about an 86-year-old with advanced dementia and cancer dies and had also been given a slightly-too-high does a few weeks earlier, is it the error that killed her or her disease and age? I would most likely say that her disease was the culprit in the death of her not the high dose of a medication. These factors should be taken into account when trying to calculate this type of statistic. But, it is also very hard to decide which events caused the death and which events are linked with the death of a patient. There is also another good statistic listed that states of 5% of deaths in hospitals may have a 50% chance of being preventable, BUT more than half of them occurred in older, sicker patients who were thought to have less than one year of life left. In no way shape or form am I saying that the death of a loved one is not a hard thing to swallow, because it is and it sucks, it’s that we shouldn’t blame the doctors, nurses, respiratory therapists and other medical professionals who tried their absolute best to try to save that patient’s life.

[@andrewandrew599]

Do you intentionally use John Green's technique of never blinking? You do it well.

[@Sakura-zu4rz]

The distinctly unpalatable truth that medicine, for all its lifesaving accomplishments, can also cause harm. Doctors were understandably desperate to help their patients, but resultant frantic prescribing, probably caused more harm than good…

[@mikaylasmith3111]

This is a little more of a touchy subject for me. As he said in the video, it is easy to know what someone dies of when they are in a car accident or are murdered, however it is much harder to know when a medical professional is in direct fault of killing a patient. Of course there are some cases where it is evident that a doctor or other healthcare professional made a major error that ended in the patients death. It is hard for me to believe that 10% of all hospital deaths were caused because of an error by a doctor or surgeon. I know that they are also human, and we all make mistakes, but there is no way that we as healthcare professionals can make that many mistakes to kill half of millions of people every single year. I do know that we all make mistakes but if that is the case and they really are killing that many people a year, then we should not have the education now that we have for medical students. If this is the case, then maybe we should have a longer program of schooling so that these students can understand better every situation and possibly lower this number. If that does not lower the number then maybe the results are not showing what we think they are and maybe a lot of people are just dying from actually being sick and not because of medical errors.

[@keylahwallace3733]

I understand your perspective on the topic. However, it is true that thinking you will be at no risk to harm going to the hospital is completely ignorant. There's many factors to why sometimes the death is linked to what the physician or healthcare staff did. Sometimes these patients don't have family or friends to disclose more important information to the staff because they aren't capable due to being demented or something along those lines. Sometimes patients do not disclose everything about their medical history, to which it makes the physician deem certain medications for the patient safe. Once administered, there can be chances that they have negative effects, including death. I have seen numerous times patients denying that they took narcotics to help with their issues, medications that were prescribed to a friend or family. If the staff has no knowledge of this, it can put someone at risk while taking ordered medications during their hospital visit. Even denying the use of alcohol or street drugs within the last 24 hours can play a role as well. There's no amount of schooling someone can take to prevent all errors in a healthcare setting. Medicine in itself isn't guaranteed. Every case is unique. Not one patient's history is exactly the same as the next person with the same age, race, and gender. They all have a different combination of ailments which makes these decisions of care more critical than others. Intentional negligence by healthcare and medical staff should hold them accountable because there is a reason why procedures are done in a certain order and ways. Like for lumbar punctures, sterile gloves and masks need to be worn and a sterile field must be placed on the patient to avoid contamination. Same goes for catheters inserted in the urethra that can cause severe infections if sterile techniques weren't used. Even the steps used to properly insert a catheter is very important. Blowing the balloon from the catheter in the bladder as opposed to in the urethra can put a patient in an ICU due to blowing the urethra. If such things occurred in a hospital setting, then yes definitely there should be something done. However, it's hard to guarantee no harm when patients walk into hospitals because these facilities are one of the most filthiest places in your area. There are so many things to take into account. I disagree that more education would fix that because it isn't always the healthcare or medical staff's fault. Sometimes these occurrences are beyond their control.

[@zachyoung6537]

2:40 - Argument from incredulity isn't an argument.

[@ResortDog]

You always have to run statistics backwards to prove your work and in the twain they only meet at the truth.

[@rachelgooden9981]

yaaaaay. my topic

[@alyssawilke4961]

Some medical errors may be preventable, but other may not be so preventable and the patient ends up dying. I feel that most medical errors can be preventable though because you work in a hospital and should know how to do your job. Example with an older person with dementia and they give her a higher dose than what she should of had and then she dies. The disease and age did not kill her, I believe she died because of the higher dose she was given while in the hospital. That could of been preventable because the nurse could have given her to right amount of dosage rather than given her a higher dose.

[@libbybihary7631]

When talking about preventable medical errors It's hard to say that they ultimately killed someone in hard cases like the ones pointed out by Aaron of Healthcare Triage. When talking about preventable medical errors you have to remember that doctors and healthcare professionals are also humans and make mistakes. The problem is the consequences of these mistakes can be so extreme and can cause a large number of deaths. In the video Aaron says the third largest cause of death in the united states are preventable medical errors, how it's explained how can that even be proven? I don't agree with how these things are done because there isn't a clear indicator if these mistakes actually causes death. People make mistakes and sometimes it has horrible consequences but what we need to focus on is a better system to catch things like this so that way it doesn't happen as often. Medical deaths aren't as clear cut as everyone makes it seems so doctors and patients need to be paying more attention to how things are done. Now, seeing as every mistake cannot be avoided the US needs a better way of counting these deaths, because right now the number is so high and we are counting deaths that could have ultimately caused by something other than error. If the US were to come up with a better system it would give patients more trust and also help with malpractice suits.

[@TheDajamster]

Maybe making sure that medical professionals can get enough sleep would be helpful.

[@yurisonovab3892]

The beard really frames your face well.

[@XxxPrussiasGirlXxx]

He sounds more defensive than usual

[@tamaboyle]

He has a lot to be defensive about.

[@peanut12345]

We know Mr Pharma pays His bills.

[@DarthLoompa]

Why aren't QALYs used in this analysis?

[@داريالليسعدهاتوماجاها]

Medical errors

[@AccuphaseMan]

This guy is sponsored by hospitals