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Being an Engaged Patient in the Age of 400,000 Avoidable Annual Deaths

January 29, 2014

By Stacey Eccleston

The data is in!—an astounding 400,000+ patients die each year related to preventable harm occurring at hospitals across the U.S.  This puts medical errors at the third leading cause of death in the U.S. The new 2013 study from the Journal of Patient Safety updates the nearly 3 decade-old figures estimated by the Institute of Medicine and should certainly cause alarm.  I know it did for me.  But what can we as patients do to avoid becoming part of that statistic?  Where does the responsibility lie for reducing that number?  Were the events that led to the deaths truly avoidable?

I think the answer to the 3rd question for the most part is a resounding yes.  Certainly not all adverse events are preventable, but the methods used for the most recent statistics are designed to narrow in on the 50 to 60% of events that are considered preventable.  The preventable harm we are talking about here includes such things as errors in the carrying out of a procedure, say accidental nicks or improper handling of equipment that lead to serious infections; errors in communication where important information is not conveyed to patients or caregivers that is vital to recovery and patient safety; and errors in diagnosis.  True, these are certainly not intentional errors, but by definition should be avoidable.   

Where does the responsibility lie for reducing that number?  I believe the responsibility primarily lies at the feet of the healthcare provider community. However, the pressure too must come from patients as well.  We, as patients, need to be involved in our care and feel confident enough to have a voice in our care.  I had an unfortunate first hand experience with a medical error that caused direct harm to me as a patient, though thankfully and obviously, not one that resulted in my death.  After being plagued with back problems for much of my adult life I underwent a lumbar laminectomy of two vertebrae on my left side.  Immediately following the surgery and for about 3 weeks thereafter I felt complete relief.  At about 3 weeks post-surgery I started to feel pain on my right side.  This went on and got increasingly worse for about another 3 weeks during which time there were several expensive diagnostic exams and visits to everyone from acupuncturists to chiropractors to pain clinics.  My surgeon noted that it could not possibly be a surgical related infection because I would be in more pain than I was exhibiting and prescribed pain medication and antidepressants.  I, of course, thought he must be right.  Nonetheless, I kept pushing to get at the cause of the pain because it prevented me from working.  After a spine biopsy, it was discovered that there was indeed an infection that was introduced at the time of the original surgery.  I was promptly hospitalized and put on an intra-venous course of antibiotics that continued for 8 weeks post discharge.  I tell this story because it did take some persistence on my part to push for the diagnosis of the infection.  I am not sure all patients feel empowered to do so; in fact, I was constantly second-guessing myself. 

Engaging in conversations with my doctors empowered me to play a part in finding the solution to my pain. As patients, we should feel empowered and feel the right to speak with our doctors, research our hospitals and listen to our bodies.

The error during surgery as well as the subsequent misdiagnoses of the infection falls into the category of preventable error that caused harm.  In this case, thankfully, that harm did not result in death, unlike it did for an unfortunate 400,000 other of our nation’s residents.