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There is a med­ical emer­gency rolling across the land and into its hos­pi­tal rooms. No drug is avail­able to cure it, and it can be as lethal as any super­bug. It is the epi­dem­ic of hos­pi­tal med­ical errors that is lit­er­al­ly killing thou­sands of patients each year and leav­ing oth­ers injured or at unnec­es­sary risk. Some experts are already call­ing it a health­care emer­gency.

In the Unit­ed States, it is esti­mat­ed that as many as 400,000 patients die from these errors every year. They range from med­ica­tion foul‐ups to infec­tions that are not prop­er­ly con­trolled. Lisa McGif­fert, man­ag­er of Con­sumers Union’s Safe Patient Project, is not exag­ger­at­ing when she says, “Giv­en the num­ber of lives at stake, the U.S. should be treat­ing patient safe­ty as a nation­al emer­gency and mount­ing a much more aggres­sive cam­paign to end med­ical harm.”

What about Cana­da? We are far from immune from this epi­dem­ic. One study claims that more peo­ple die from med­ical errors in Cana­da than from breast can­cer, motor vehi­cle acci­dents and HIV‐AIDS com­bined. It is the third lead­ing cause of death in this coun­try, as it is in the Unit­ed States.

Med­ica­tion errors are a large part of the over­all prob­lem. And they are wide­spread in the hos­pi­tal set­ting. Most nev­er get report­ed. My moth­er was sub­ject­ed to seri­ous med­ica­tion errors dur­ing three dif­fer­ent hos­pi­tal­iza­tions. One involved an aller­gic reac­tion to a steroid giv­en in a mas­sive dose when the doc­tor would not lis­ten to the family’s warn­ings. That result­ed in a four‐week hos­pi­tal admis­sion. Three years lat­er, she devel­oped the hideous and often dead­ly infec­tion known as C. dif­fi­cile as a result of a com­bi­na­tion of drugs that nev­er should have been pre­scribed togeth­er. Two years after that, she was sub­ject­ed to a shock­ing num­ber of med­ica­tion errors, rang­ing from drugs giv­en by the wrong route, extra dos­es and missed dos­es, to drugs that were improp­er­ly pre­pared, admin­is­tered and mon­i­tored. And she was just one patient.

Anoth­er, and very well‐documented, hos­pi­tal night­mare for a still‐grieving fam­i­ly seek­ing answers in the trag­ic loss of their moth­er is set out here. Like many fam­i­lies whose loved ones have been betrayed by a hos­pi­tal, they are seek­ing to change what is too often an unac­count­able health­care sys­tem.

There are numer­ous rea­sons that have been put forth as to why there con­tin­ue to be so many med­ical errors. Some almost approach the‐dog‐ate‐my‐homework lev­el, rang­ing from bad hand­writ­ing by doc­tors to bad hand hygiene by clin­i­cal staff. Obvi­ous­ly, they didn’t have the ben­e­fit grow­ing up as I did of a fas­tid­i­ous moth­er on both counts. Anoth­er com­mon excuse is that so many errors don’t get report­ed because doc­tors and nurs­es fear the reper­cus­sions if they are dis­closed. Since it is almost impos­si­ble in Cana­da, at least, for an ordi­nary fam­i­ly to suc­cess­ful­ly sue doc­tors or nurs­es, giv­en the tax­pay­er financed legal arse­nal hos­pi­tals and insur­ance com­pa­nies have at their dis­pos­al, these so‐called reper­cus­sions clear­ly aren’t the kind that hit the pock­et­books of health­care providers.

Many experts sug­gest what is need­ed is a blame‐free hos­pi­tal cul­ture that won’t point the fin­ger at any cul­prit. They say this will encour­age bet­ter error report­ing. But will it pre­vent the errors from occur­ring? What would hap­pen if our traf­fic laws had no con­se­quences for peo­ple who could just claim they made an hon­est mis­take when they were speed­ing or went through a red light? Just admit the wrong and move on? Where else in soci­ety does it work that way?

In fact, per­haps what is required is not a no‐fault cul­ture, but one where it actu­al­ly becomes unlaw­ful not to report med­ical errors. Cer­tain­ly — and you have not seen this idea advanced any­where else, nor are you like­ly to — the Crim­i­nal Code of Cana­da should be amend­ed to make it a crime for a hos­pi­tal to inten­tion­al­ly destroy records or oth­er­wise attempt to con­ceal and cover‐up the facts relat­ed to med­ical errors and harm. That might make clin­i­cians and hos­pi­tal admin­is­tra­tors think twice before they engage in a prac­tice that, at least in terms of the per­cep­tions voiced by many fam­i­lies, occurs all too fre­quent­ly.

It did on a shock­ing scale in the case of my moth­er as well. The laws should also be changed so that each province requires hos­pi­tals to report in detail on all the errors that occur and gives the pub­lic access to that infor­ma­tion. Right now, only Que­bec and Saskatchewan make such wide‐ranging pro­vi­sions manda­to­ry.

Think about all that you have read on breast can­cer research and efforts to reduce motor vehi­cle acci­dents. Now, com­pare that to how much you know and have read about the cam­paign to reduce hos­pi­tal med­ical errors, which claim more lives each year than these oth­er two high‐profile caus­es com­bined. In light of this, it is puz­zling that the media have not grav­i­tat­ed to this issue by report­ing on it in any sig­nif­i­cant way and give it even less ink in inves­ti­gat­ing its caus­es. Clear­ly, the pro­tec­tion of the pub­lic requires that med­ical errors be treat­ed as the nation­al health­care epi­dem­ic they are. Just ask any patient or fam­i­ly who has suf­fered harm. Noth­ing less is accept­able.

[Update on the removal of life sup­port by doc­tors and relat­ed DNR issue:]

This week, Britain’s high­est court ruled in favour of a hos­pi­tal that gained court approval to with­hold treat­ment from a ter­mi­nal­ly ill man despite the family’s oppo­si­tion. In com­ing to its deci­sion, the court not­ed that doc­tors had esti­mat­ed that the patient had a one per­cent chance of sur­vival with the treat­ment.

When doc­tors sought a DNR order from me imme­di­ate­ly after my mother’s hos­pi­tal­iza­tion with a seri­ous brain injury, they also said that any­one over 80 has a less than one per cent chance of sur­viv­ing a car­diac arrest. Had I act­ed on that sta­tis­tic, or if the law had allowed physi­cians to make the DNR order over my objec­tions, I would not have heard these price­less words from my moth­er last night as she calm­ly drift­ed off to sleep: “I love you, dear.”

Pub­lished in The Huff­in­g­ton Post, Novem­ber 1, 2013

A recent arti­cle in The Atlantic called “The Hos­pi­tal is No Place for the Elder­ly,” rais­es trou­bling con­cerns about the future of health­care for the elder­ly.  Here is an excerpt: Seniors with five or more chron­ic con­di­tions account for less than a fourth of Medicare’s ben­e­fi­cia­ries but more than two‐thirds of its spending—and they are […]

The bur­dens of care­giv­ing can­not con­tin­ue to be borne by the typ­i­cal middle‐aged woman who is too worn‐out to voice out­rage or too depressed to advo­cate for a fair­er deal, while soci­ety reaps all the sav­ings in health­care costs. When we think about med­ical errors in hos­pi­tals or nurs­ing homes, we often think about the […]

What if an epi­dem­ic wiped out the entire pop­u­la­tion of Dal­las and con­tin­ued on to Cana­da to kill every­one in Kingston, Shaw­ini­gan and Vic­to­ria?   Just the pos­si­bil­i­ty would be enough to cre­ate a North American‐wide health­care emer­gency.  Yet med­ical errors in the Unit­ed States will kill, by con­ser­v­a­tive esti­mates, some 1.2 mil­lion peo­ple between 2014 […]

There is a med­ical emer­gency rolling across the land and into its hos­pi­tal rooms. No drug is avail­able to cure it, and it can be as lethal as any super­bug. It is the epi­dem­ic of hos­pi­tal med­ical errors that is lit­er­al­ly killing thou­sands of patients each year and leav­ing oth­ers injured or at unnec­es­sary risk. […]

DNR Decisions Need Rules to Protect Patients and Families

DNR Decisions Need Rules to Protect Patients and Families">

NDR Deci­sions Need to be Made a Whole Lot Safer, More Trans­par­ent and Less Emo­tion­al­ly Harm­ful  for Patients and Fam­i­lies.  A recent land­mark rul­ing by the Supreme Court of Cana­da reject­ed a doctor’s uni­lat­er­al right to deny life‐sustaining med­ical treat­ment to a patient over the family’s objec­tions. Atten­tion needs to turn now to anoth­er life […]

The CBC’s White Coat/Black Art has come up with anoth­er stun­ner: clin­i­cians in some sit­u­a­tions where they think a resus­ci­ta­tion is not real­ly appro­pri­ate will go about it so slow­ly that it amounts to a DNR.  They even have a name for it: Slow Code.  Just when you think decep­tion in health­care can’t get any worse, […]

Many Cana­di­ans have learned the hard way that their health­care sys­tem is not near­ly as safe as it needs to be. Lack of ade­quate account­abil­i­ty is keep­ing it that way. And the rea­son, as more and more are dis­cov­er­ing, is because it works so well for hos­pi­tals, pol­i­cy mak­ers and, now, lawyers. My family’s eye‐opening […]