Despite continued progress in patient safety rules, the number of patient injuries and death due to errors by medical staffs at hospitals in Massachusetts has not gone down. This revelation comes in a report from the Betsy Lehman Center for Patient Safety, a Massachusetts state agency created to improve patient safety and reduce the number of medical errors. The report, titled The Financial and Human Cost of Medical Error, was published on June 10, 2019. It finds that the Massachusetts “health care system remains prone to error and there are no easy fixes.”
To get the information contained in the report, the authors searched through patient medical and billing records and also interviewed people in 5,000 Massachusetts households. The results are troubling to say the least. In 2017, there were approximately 62,000 medical errors in Massachusetts. Those medical errors led to almost $620 million in medical care that patients would not have needed if they had received proper care. That breaks down to 170 medical errors per day with an average cost of $10,000 for each error. Of those 170 medical errors a day, 30% caused serious harm to the patient and 12% of medical errors caused a patient to die. The medical errors happened in emergency rooms, inpatient hospitals, urgent care centers, nursing homes and retail pharmacies.
The household interviews showed that 1 in 5 Massachusetts residents had a recent experience with a medical error, either themselves or through a family member. Patients reported being unhappy with the communication they had with medical providers after an error, which caused the patients to be less trusting of doctors and other medical providers. Separate from the cost of the treatment needed because of the medical error, patients also reported that they have experienced serious financial problems because of medical errors, including lost income and increased out-of-pocket medical expenses.
The Betsy Lehman Center report gives suggestions on ways that Massachusetts can improve on patient safety to prevent medical errors from occurring. The report states that increased transparency and accountability for doctors and hospitals is one of the ways to improve safety. The report does not mention one serious obstacle to transparency and accountability – all reports that hospitals are required to submit to the Betsy Lehman Center when a “Serious Reportable Event” has occurred are not public record. Massachusetts General Law Chapter 12C, Sec. 15 states that any information a hospital reports to the Lehman Center “shall not be a public record as defined in section 7 of chapter 4, shall be confidential and shall not be subject to subpoena or discovery or introduced into evidence in any judicial or administrative proceeding, except as otherwise specifically provided by law.” Simply put, information about medical errors is made secret by this law. A patient harmed by a medical error may never know that the hospital has reported the error. And if that patient decides to file a medical malpractice case for any damages caused by a medical error, the information that the hospital or medical provider provides to the Betsy Lehman Center cannot be used in that lawsuit – even if the hospital reports that an error caused serious harm to the patient, it is free to argue in the lawsuit that it did nothing wrong. Massachusetts’ Peer Review law also makes all hospital investigations into medical errors secret so that the patient never finds out if what happened to him/her could have been prevented. Again, a hospital’s internal investigation can determine that a doctor made a serious error that caused a patient to die, but the hospital and its lawyers are free to argue in a medical malpractice case that the doctor did nothing wrong. This makes no sense at all. If the Betsy Lehman Center believes that transparency is one of the keys to improving patient safety and reducing the number of serious injuries and deaths caused by medical errors, it should take steps to remove the secrecy about medical errors. Insurers, doctors, and hospitals have lobbied for years to put strict restrictions on patients being compensated for medical errors (medical malpractice lawsuits). They have also tried to make medical malpractice lawsuits appear to be frivolous and a driving factor in the cost of healthcare. These claims have been repeatedly debunked. There is no “crisis” of medical malpractice claims, which have been dropping steadily for years. A reduction in malpractice cases or limits on patient recoveries has no effect on insurance rates for doctors and would not cause a drop in healthcare spending. The Betsy Lehman Center’s report makes clear that the real crisis is that patients continue to be seriously harmed and even killed by medical errors. The impact of these errors is felt by everyone. The costs of the treatment for these errors are passed onto other patients through higher health insurance and medical costs – essentially, patients and every other holder of healthcare insurance subsidize the costs of these medical errors. Even though only a tiny fraction of patients harmed by medical errors end up filing a medical malpractice lawsuit, these lawsuits are often the only means available to patients to acquire the continuing care they need to address complications caused by these medical errors and to provide for their families.
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