Say you’re sorry—and then fix the system

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One year ago, four medical mistakes occurred over 54 days in the same unit at Alberta Children’s Hospital. A four-year-old patient was given a 15-fold overdose of a narcotic; another was given an accidental overdose of a drug to suppress the immune system. A two-year-old received multiple medications through an IV instead of a stomach tube and a nine-day-old baby received the wrong breast milk.

Something is obviously wrong and until parents of little patients know exactly what the problem is, they will likely be sitting beside their children, day and night, questioning doctors and nurses about every medication and every procedure. At least, they should.

It isn’t good enough for the Health Quality Council of Alberta, who investigated the situation, to release a two-page executive summary of its 58-page report. Fortunately, the public outcry over this lack of transparency “encouraged” Health Minister Gene Zwozdesky to do the right thing and direct the agency to release the full report.

But the problem won’t end there. Studies indicate chances are relatively high that hospital patients will experience an adverse event—even one that leads to death.

The Canadian Adverse Event Study, published in 2004, appears to be the most comprehensive evaluation of medical errors and the news isn’t good. Canadian hospitals have a 7.5 per cent rate for adverse effects, meaning that something goes wrong in one of 13 hospital visits. It was determined that about 70,000 of 185,000 errors were preventable and almost 24,000 Canadian patients die every year as a result of preventable adverse effects.

In a 2005 Stats Canada survey, one in five nurses (19 per cent) acknowledged that, during the previous year, medication errors for patients in their care occurred either “occasionally” or “frequently.”

A 2005 international study showed Canada had the second-highest rate of medical mistakes. Approximately 30 per cent of Canadians surveyed experienced some error with their health care. It’s enough to make one wonder if anything goes right in our medical system.

Just ask Licia Corbella, the editor of the Calgary Herald. She was confined to hospital bed rest at 30 weeks gestation of her twin pregnancy. The goal was to keep the twins inside as long as possible. Yet, one day, the same nurse who had cared for her for two weeks and who was supposedly well acquainted with the reason for her hospitalization, attempted to give her an injection to induce labour. Oops.

Years ago, I had an operation to remove cartilage chips in my right knee. I recall waking up with both knees bandaged and double the pain. The doctor was apparently so involved in teaching arthroscopy to his students that he operated on the wrong knee.

In the past, mistakes like those were often dismissed or shoved under a rug. Today, health boards seem willing to institute changes when procedures are faulty or to discipline doctors and nurses. Surgical checklists have reduced the risk of errors by as much as 30 per cent through simple checks—like confirming which body part is to undergo surgery. Transparency may still be lacking, but it’s improving.

Apology protection laws have been a big part of bringing medical errors into the open. This legislation (already in effect in provinces from B.C. to Ontario) allows doctors and nurses to apologize to patients when errors are made without fear of being held liable or voiding their insurance coverage.

Apologies have reportedly been offered to those who experienced errors at ACH. That’s a good first step, since it counteracts the tendencies for health officials to deny responsibility and victims to run to lawyers. Now it’s time to deal with the problem openly and ensure this doesn’t happen again.

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