A doctor speaks about medical malpractice

It is unusual for doctors to report errors caused by medical malpractice – either those they commit or those they experience. So a recent Op-Ed piece in the New York Times represents a call to action by at least one medical professional. 

Dr. Frederick S. Southwick describes the amputation of his left leg after a blood clot formed. He speculates about the origin of the blood clot, ultimately deciding that the clot originated from the too-tight pressure cuff used during ankle surgery many years previously. The injured blood vessels scarred and calcified blocking all blood flow to his leg.

The irony, according to Dr. Southwick, is that he has been a leader in trying to prevent medical errors. And despite the efforts of many other physicians like him, little progress has been made.

Or that’s what he thinks. However, he notes that it is actually impossible to count the number of deaths and injuries caused by medical mistakes. There is no system of national reporting. So saying that there has been no improvement is really a guess.

The best numbers available are more than 10 years old. A major study undertaken by the Institute of Medicine estimated that between 44,000 and 98,000 preventable deaths occur each year because of medical error. The study also assumed that for every death there are 10 injuries, making the total number of preventable medical injuries and fatalities around one million.

Dr. Southwick states that the reason for an unchanging medical error rate is that medical professionals have been unwilling or unable to change their approach to the practice of medicine.

He recommends that the medical profession adopt the kind of safety measures common in manufacturing and points to alarms and automatic shutoffs as simple but effective measures that would make it more difficult for doctors and nurses to do the wrong things.

He points to his own situation. If there had been an alarm to alert physicians to how long the cuff was used, or if it had automatically deflated after a certain period, the blood vessels in his leg might never have been damaged.

But what is most important, he says, is better communication and a willingness to address the problem of medical malpractice. He points to the controversial Affordable Care Act as a start – a recognition that the medical system needs an injection of evidenced-based treatments and reimbursement schedules to ensure that the practice of medicine harms fewer patients.

Source: New York Times, “Losing My Leg to a Medical Error,” by Frederick S. Southwick, Feb. 20, 2013.