This article underscores the abject failure of medical error reporting programs – and laws that require reporting – because no one is really trying to enforce the laws that already exists in 27 states, including Maryland, requiring hospitals and other facilities to report serious medical malpractice.
Every once in a blue moon, a hospital does get caught. Last year, Doctors Community Hospital in Prince George’s County was fined $30,000 by Maryland health regulators after failing to notify them that a patient had died and that at least seven others suffered serious harm as a result of medical malpractice. But the practical reality is that a $30,000 fine is a drop in the bucket for a large hospital and the chances of getting caught covering up medical malpractice in Maryland are extremely low.
As I discussed yesterday, a process tort of failing to disclose or conceal would be a viable solution. But MedChi lobbyists are never going to let the Maryland legislature create a statute that creates a new tort and the “stare decisis is king” Maryland Court of Appeals is not likely to create a controversial new tort anytime soon.
Medical Error Reporting Statistics
The following studies report that electronic health record systems (EHRs) have serious consequences for both patient safety and trust.
A 2019 study published in the Journal of Patient Safety examined around 250 EHR-related medical malpractice claims. They discovered that:
- 59 percent of cases involved ambulatory care, 31 percent involved in-patient care, and 10 percent involved emergency care.
- 31 percent of cases involved medications, 31 percent involved treatment complications, and 28 percent involved diagnoses.
- Over 80 percent of cases “involved moderate to severe harm.” However, fewer ambulatory care cases involved fatalities compared to in-patient and emergency cases.
- Regarding medication errors, 46 percent involved medication orders, 25 percent involved improper medication management, and 16 percent involved administration errors.
- 43 percent of diagnostic error cases involved fatalities. Over 60 percent involved user-related errors, while 42 percent involved technology-related issues. Two cases involved both. Around 76 percent of the user-related errors were ambulatory cases.
- 40 percent of diagnostic error cases involved a delayed cancer diagnosis, 36 percent involved acute issues including a heart attack, pneumonia, a pulmonary embolism, and other infections. Delayed fractures, HIV diagnosis, and post-operative complications cases comprised the remaining ones.
A study published around May 2020 in JAMA concluded that Electronic Health Records systems (EHRs) continue to have a mixed safety record. Researchers found that:
- EHRs failed to detect about one-third of medical errors.
- In 2009, EHRs only detected around 54 percent of errors. By 2018, they detected around 66 percent of them.
- The researchers found that EHRs only met basic safety standards around 70 percent of the time.
A study published in JAMA around June 2020 examined patient reporting of EHR errors. Researchers surveyed around 30,000 patients on their ambulatory care notes. They discovered that:
- One-fifth of those surveyed reported finding errors in their records. Around 42 percent of these individuals thought they were serious.
- The most commonly reported errors involved diagnoses, medical history, medications, physical examinations, test results, sidedness, and notes intended for a different patient.
- Sicker and older patients were more likely to report serious errors than healthier and younger patients.
- More educated patients were also more likely to report serious errors.
- There was no significant difference in reporting between black and white patients or Latino and non-Latino patients. However, Asian patients were less likely to report serious errors than white patients.
Medical Error Statistics
The following statistics highlight the medical errors that faulty medical record systems miss:
- According to a 2016 Johns Hopkins study, medical errors are the third most common cause of death in the United States. The study found that they caused over 250,000 deaths annually. This accounts for about 10 percent of all annual deaths. Some estimates are as high as 400,000.
- A 2017 Institute for Healthcare Improvement survey found that 21 percent of Americans reportedly experienced a medical error. It also found that 31 percent of Americans reportedly knew someone who experienced one.
- A Surgery journal study found that surgeons made over 4,000 “never event” errors, including wrong-site surgery.
- A Joint Commission study reported on medical errors it labeled as “sentinel events.” Researchers found that between 2015 and 2018, the top five sentinel events involved retained surgical items, wrong-site surgeries, falls, suicides, and treatment delays.
- A survey published in Mayo Clinic Proceedings found that about one in 10 surveyed physicians reported making a severe medical error within the last three months. It found that physicians experiencing burnout were over twice as likely to self-report. The survey also found that low hospital safety grades increased this medical error risk by three to four times.
- Johns Hopkins’ Armstrong Institute for Patient Safety and Quality found that hospitals could save over 33,000 lives if they performed at safety levels comparable to hospitals receiving the Leapfrog Group’s “A” grade.
- A Nursing article found that between 49 and 53 percent of medical errors involve recent RN graduates with less than one year of patient care experience.
- Medical errors annually cost about $20 billion.
- A 2019 Betsy Lehman Center for Patient Safety survey that looked at individuals suffering from medical errors. It found that these errors negatively impacted patients’ financial, physical, and emotional wellbeing.
- About half reported experiencing financial hardships, including loss of work and high medical bills.
- About one-third of respondents reported that they or their loved one experienced negative physical health effects for a year or more.
- Over two-thirds of respondents lost trust in health care providers.
- Among those whose medical error took place three to six years ago, about one-third still feel anxious, over one-quarter still feel sadness or anger, and over one-fifth still feel depressed.