Lurking just behind heart disease and cancer, the 3rd leading killer of Americans isn’t a disease, but the medical field itself. Recent reports suggest that medical errors potentially kill more than 250,000 people per year. These entirely preventable errors cost the nation $50 Billion in annual healthcare expenses.
Currently, there are no federal regulations requiring states to report medical mistakes; however, 27 states have taken it upon themselves to demand such reporting. Among them, California is perhaps the strictest. When it fines hospitals for committing serious errors, it also publicly advertises those errors in order to add insult to financial injury — and to warn patients about certain hospitals. California is the only state that publicly punishes hospitals whether they promptly self-report errors or not.
Since 2007, the California Department of Public Health (CDPH) has issued $17 Million in fines to 192 different hospitals. Amongst those 192 hospitals, 11,749 serious mistakes were made. Dr. Michael Hicks, of UNT Health Science Center at Fort Worth describes the death toll as such: "if you look at the numbers...[medical errors are] equivalent to a couple of 747s crashing every day."
And yet, for all of this effort and all of these punishments, deaths haven’t gone down. If anything, they’ve gone up since the program’s introduction nearly a decade ago. While states are trying to protect the public, their strategies so far haven’t been up to the task. It’s time now for individual patients to understand the dangers surrounding them and to learn how they can advocate for their own health and security.
Some of the Most Serious Medical Errors Are Also the Most Avoidable
The purpose of the of the public penalty system in California isn't to demonize or punish doctors, but to continually hold healthcare to a higher standard. To be fair, life-threatening errors only occur in less than 1 percent of medical cases in California. That said, when they do happen, they aren't subtle, technical errors, but shockingly critical mistakes.
In 2014, 258 patients had a foreign object left in their bodies, 847 patients died of bedsores, 30 patients died of having surgery performed on the wrong part of their body, and another 14 died of receiving an incorrect surgery altogether. And these are just a few examples of the startling ways that patients suffer.
One of the most upsetting forms of malpractice occurs during birth injury cases. One study found that in 2006 there were 157,700 avoidable birth injuries to both mothers and newborns. Provided they don't kill the mother or child, birth injuries can leave infants with lasting, severe medical conditions such as cerebral palsy or Erb’s palsy.
Fines and Mandatory Reporting Publicize the Problem but Don’t Fix It
Despite its stringency, California's penalty system hasn't done much to reduce the number of medical errors in the long term. When the program began in 2007, California hospitals experienced slightly under 1,000 errors. In 2014 there were 1,300 errors. Quite simply, penalties don’t prevent mistakes.
At best, it could be said that fines do nothing to deter errors, but do spread awareness of their danger. A grimmer but maybe more realistic perspective is that fines and public shaming of hospitals actually prompt doctors to cover up or ignore their mistakes out of fear. After investigating patient Medicare files, the U.S Inspector General found that only 12 percent of almost 800 total medical errors in these states were reported.
Fines and Public Shaming Lead to Inaccurate Data That Hurt Patients and Hospitals Alike
Part of this oversight is likely caused by hospitals deliberately withholding data to avoid criticism in the media. But another factor is the general inefficiency of state health departments. In an article published in The San Diego Tribune, journalists stated that the CDPH was largely non-responsive to requests for information. When the department did provide data, it was incorrect and incomplete.
This inaccurate data casts suspicion on state officials who could be seen as being too lenient on hospitals. Additionally, poorly maintained records make it difficult for officials and state representatives to accurately measure the effect of forced reporting and penalties. Though 1,283 errors were reported in California for 2014, The San Diego Tribune points out that, statistically, the real figure could very well be anywhere between 20,000 and 40,000.
As a result, the attempt to crack down on malpractice through legislation indirectly causes more mistakes to go unnoticed.
The Race to Zero: How Can States Reduce Serious Medical Errors to Nothing?
Penalties may or may not be promoting public awareness of medical errors, but they also drain hospitals of money that could be better spent. Fines paid to the Department of Public Health don't necessarily get reinvested in hospitals or their staff. If instead of fining these facilities, the state could mandate that they requisition funds for training, better equipment, or additional staff.
However, a major legislative move like this is destined to be bogged down by bureaucracy. It could be years before the current system is improved. The best course of action for medical error victims right now is to seek compensation through the court system.
Patients Can – and Are – Seeking Justice for Medical Malpractice
In late June of 2016, Lisa Ewing of Chicago won a lawsuit against the University of Chicago Medical Center. During the delivery of Lisa’s son, Isaiah, staff at the center committed 20 errors. Doctors and nurses allowed Isaiah to suffer a lack of oxygen at several points during the birthing process and as a result, he was diagnosed with cerebral palsy. The condition will cost Lisa huge sums of money in treatment and specialist help, not to mention profoundly impact Isaiah’s life.
Though it took 12 years after the birth of her son to finally receive compensation, Lisa was successful. A Jury awarded Lisa and Isaiah $53 Million to cover the cost of both short and long-term damages.
Ms. Ewing’s case doesn’t show that doctors on the whole are negligent or uncaring, but it does reveal that patients who feel otherwise helpless can seek justice through the courts. It’s not a perfect solution, but until better legislation can be passed, it at least offers hope to those most in need.