You hope at least three things are true if you require hospital care.
If you need your left arm amputated, you hope a dyslexic surgeon doesn’t whack off the right arm.
If you need surgery, you’d prefer they don’t sew up the incision and leave what medical folks call “a foreign object” inside your corpus. And by foreign object we don’t mean a Volvo cup holder. It’s usually some surgical appliance, gauze or blood vessel clamp.
And third, you really hope careless human inattention does not kill you.
The Indiana State Department of Health has issued an annual report on these serious mistakes since 2006. These are not malpractice misjudgments, but rather human, institutional indifference.
The news this week seems pretty heartening for 2014, if you trust any system dependent on hospitals reporting their own mistakes.
According to all the hospitals in Indiana, they didn’t kill a single patient in 2014 who wouldn’t have died anyway from whatever sent them to the hospital. Of course, that does not account for a few who died after falls. Liability lawyers will have to negotiate if those were clumsiness or bad care.
You feel bad when somebody dies in a hospital, and especially when the hospital kills them.
Of the 114 incidents reported by Hoosierdom’s 287 hospitals and ambulatory surgery centers, most (44) were third- or fourth-degree bedsores, an issue related to nursing care.
Of course, Indiana surgeons were not perfect. Indiana surgical teams left 27 “foreign objects” inside patients and operated 21 times on the wrong body part.
Gary’s Methodist hospital shows up No. 3 on the state list with seven errors, all advanced bedsore cases acquired during hospitalization. The rate is statistically significant because Methodist handled only 14,337 procedures.
No other hospital in the state reported as many bedsore cases.
IU Health’s five-hospital empire in the Indianapolis area was No. 1 with nine errors, but it handled 61,066 procedures. Three were operations on the wrong body part.
St. Vincent in Indianapolis was No. 2 and had eight reported errors from 29,200 procedures.
Elsewhere locally, Community in Munster left one foreign object and administered one potentially fatal medication in error; Franciscan St. Margaret in Dyer had two cases of misplaced foreign objects, St. Anthony in Crown Point had one bedsore case, and St. Catherine in East Chicago had one left-behind foreign object. Franciscan Munster, Franciscan St. Margaret in Hammond, St. Mary’s in Hobart and Porter Regional had no reported errors.
But the question is not who wins the state race but whether the statistics are valid at all.
According to the public policy journalism researchers at ProPublica, perilous hospital errors have been a steamy topic since 1999 when the Institute of Medicine published the famous “To Err Is Human” report, which strafed the medical community by reporting that up to 98,000 people a year die because of hospital mistakes. Can’t be true, hospitals yelled. Now the statistic is widely accepted.
But every time refined data is run through the statistical meat grinder, the number goes up. Does that mean care is getting worse or that we now know more about medical negligence? In any event, ignorance is not bliss.
In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 Medicare patients in any given year.
A study from 2013 in the Journal of Patient Safety says the number might be — now hold your breath — between 210,000 and 440,000 patients who suffer what the study called “preventable harm that contributes to their death.”
That’s a genteel researcher way of saying the hospital killed them.
And that number, if it’s close to accurate, would mean hospital negligence is the third leading cause of death in America behind heart disease and cancer.
In 2009, author David Goldhill’s article in The Atlantic framed the body count another way.
He noted that twice as many die from avoidable infections and injuries in hospitals as die from car accidents. Five times as many die unnecessarily in hospitals as the annual number of homicides.
Another report in 2011 by “A Day In Health” suggests that medical safety statisticians fear every self-reporting mechanism is only vaguely accurate, and that American hospitals might miss 90 percent of their errors.
In fact, that puts the wrenching toll at 1 million needless deaths a year.
That would make hospitals the No. 1 cause of death in America.
