Hospital Errors – No Disclosure

Hospitals and doctors, according to a recent study, rarely admit their mistakes. Deflecting responsibility and avoiding blame are traits that society associates with schoolchildren but not with accomplished professionals, like doctors, or respected institutions, like hospitals.

Unfortunately, a study conducted by ProPublica found that only 20 percent of patients and their families received notice from a hospital or doctor that an error occurred. Furthermore in about half of those families that did receive a disclosure, only received the disclosure after some form of pressure was applied – like a lawsuit.

The Study

ProPublica interviewed more than 1,000 people who personally suffered or had a family member suffer an injury during medical care. The respondents completed a detailed questionnaire that reviewed the medical treatment sought, the nature of the error and, if applicable, the disclosure. The study included patients or family members in all 50 states.

Sadly even while one in five respondents reported that a disclosure occurred, only one in eight received an apology for the error. This study illustrates what some experts call, a gaping hole in the health care system. Keep in mind that this study, while demonstrative, was not conducted with statistical cross-section principles. The study only interviewed people who were self-selected, so it is not an accurate reflection of the rate of disclosure or apology, it is mere to illustrate the problem in the health care system.

The Problem

A study conducted by the Institute of Medicine advocated creating a national registry to track medical errors and to bring greater accountability. At first blush, this might sound unnecessary. However, according to a recent study, between 210,000 and 440,000 patients die due to preventable injuries in hospitals. Many studies place medical errors as the number three killer in the United States, after heart disease and cancer.

Unfortunately, no national registry materialized. To date, only ten states require hospitals to disclose medical errors or unintended outcomes. Moreover, two-thirds of states grant immunity to health care providers that apologize for committing such errors.

Doctors sound the alarm as well. Every error that is swept under the rug is a missed opportunity to improve care. Doctors are scientists who rely on the dissemination of knowledge when techniques or practices no longer work. The health care system needs hospitals and physicians to disclose errors to allow doctors to study the failure to prevent future mistakes.

The problems don’t end with hospitals and physicians – the regulators have a disclosure issue as well. One family who lost a loved one after repeated preventable mistakes committed by hospital staff attempted to involve state regulators and the Joint Commission which oversees and accredits hospitals; both institutions declined to investigate or punish the hospital.

Medical Malpractice

Medical malpractice lawsuits are a solution in some of the situations, but not all. Lawyers can help families, and patients find answers and receive just compensation for their injuries, but there is a limit to what a lawyer can do.

Medical malpractice lawsuits are expensive to undertake. Lawyers need money and time to prepare depositions and hire expert witnesses to prepare reports. All of these steps are necessary because the plaintiff must prove that an error occurred, only another doctor can point out medical mistakes.

All of these expenses amount to a limited budget for lawyers to execute these lawsuits. Unfortunately, due to the high cost, many law firms are unable to litigate every case – even if there is merit. The problem is that the recoverable damages (compensation) are limited by statute. Specifically, most damages are limited to actual medical bills and lost future wages.

Tragically, limitations on recoverable damages mean that it isn’t always economical for a law firm to litigate a case, even if there is merit. For example, a young child or retiree likely has little or no income. Therefore the law firm may not be able to recover enough damages to cover the cost of litigation.

Individual Solutions

Not all hospitals are taking a “deny and defend” approach to medical errors. Several studies indicate that many patients and their families initiate medical malpractice lawsuits to find answers.

Dr. David Mayer, Vice-President of Quality and Safety at MedStar Health, a Maryland hospital chain, is among a handful of hospital administrators that is experimenting with a new disclosure policy. The program, which is funded by a federal grant, requires caregivers to admit mistakes, apologize that they occurred and that their loved one suffered harm due to that error.

This program instructs caregivers to inform patients immediately of mistakes. In contrast, the standard operating procedures at most other hospitals do not permit disclosures until after an internal investigation is completed. According to Dr. Mayer, this approach is unacceptable because it ignores the emotional needs of the patients and their families.