Medical errors


Published: Tuesday, January 28, 2003 at 6:01 a.m.
Last Modified: Monday, January 27, 2003 at 10:42 p.m.

When musician Maurice Gibb died at a Miami Beach hospital earlier this month, the family raised questions about the quality of care.

"We believe mistakes were made," his brothers told the British Broadcasting Corp. "We will pursue that relentlessly. That will be our quest from now on."

Did a medical error cause Gibb's death? It would not be surprising.

A landmark 1999 report by the Institute of Medicine (IOM) found that somewhere between 44,000 and 98,000 Americans die in U.S. hospitals each year, not from the illness or injury that brought them to the hospital, but from a preventable medical mistake.

Even the most conservative estimate means that more people die of medical errors than automobile accidents.

Gibb is not the first celebrity to be hurt by medical errors. A few years ago Dana Carvey, the well-known comedian, former ''Saturday Night Live'' cast member and father of two, underwent double bypass heart surgery to save his life, only to find out that the surgeon had bypassed the wrong artery.

If celebrities like Gibb and Carvey can't get adequate care, what chance do the rest of us have when we seek health care?

Since the IOM report was issued, the health care industry has taken steps to cut down on preventable mistakes. Some surgeons use a waterproof marker to clarify the surgery site.

New computer programs have eliminated problems with ambiguous physician handwriting, and helped minimize confusion between drugs with sound-alike names, such as the arthritis drug Celebrex, the anticonvulsant Cerebyx, and the antidepressant Celexa.

A study in the New England Journal of Medicine last month found that in a survey of physicians, 35 percent had observed medical errors. However, most doctors did not consider reducing medical errors to be a top health care concern.

The survey also showed that the public and many physicians support sanctions against health professionals who are responsible for serious errors.

In Florida, the body responsible for policing the medical profession is the Florida Board of Medicine. But the group has not impressed consumers as looking out for their best interests.

In 2001, a health care activist resigned from the board in protest when it failed to revoke the license of a cosmetic surgeon accused of disfiguring the faces of five women and botching a liposuction that may have led to the death of another patient.

Last February, the board approved a plan that made Florida the first state in the nation to significantly lower standards for doctors who advertise themselves as "board-certified," no longer requiring a residency in that specialty. (Previously, the Veteran's Administration had turned down that certification process, saying it was not "in the best interests of assuring quality care for veterans.")

While the total number of disciplinary actions against physicians in Florida has increased in the past few years, the penalties assigned are much more lenient than in other states, according to the advocacy group Public Citizen.

Far too often, offenses that would have merited license revocation or suspension in other states are only fined in Florida.

Perhaps it is time for standards that are uniform throughout the nation to prevent bad doctors from moving to more lenient states like Florida. Florida needs a state board that has some teeth to it. This would reassure patients, and would eventually benefit physicians as well.

Both state and national leaders have vowed to "do something" about the high cost of medical malpractice insurance, which has already caused many good doctors to think about moving out of Florida.

But as things stand, many patients don't trust doctors, and view a lawsuit as the only recourse they have in cases of sub-standard care. Only when patients are assured that a mechanism exists to effectively weed out bad doctors will the public support caps on malpractice awards.

A big step toward improving the malpractice climate in Florida would be to strengthen the Florida Board of Medicine.

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