This comes from the April 2001 issue of Good Housekeeping.  I tried to 
find a copy of the article online but I only found this:

http://204.29.171.80/framer/navigation.asp?charset=utf-
8&cc=US&frameid=1565&lc=en-
us&providerid=113&realname=Good+Housekeeping&uid=3641534&url=http%3A%
2F%2Fwww.goodhousekeeping.com%2F

Which is probably too long to really work as a link.  What I'm going 
to do instead is put in the original article directly from the 
magazine (not online) and then, in subsequent posts, put in some of 
the stories that they quote.  For those of you with the aforementioned 
issue, the article is on page 136.

By the way, this is likely to be a long one, so bear with me, okay?

WHEN DOCTORS MAKE MISTAKES

"Misread pap smears.  Lost lymph nodes.  The wrong diagnoses.
Each year some 98,000 people die as a result of medical errors."

"When Laurie Kastrup of Upper Saddle River, New Jersey, found a lunp 
in her breast in September 1994, she immediately consulted a top 
breast cancer surgeon at Columbia Presbyterian Medical Center in New 
York City.  Kastrup, then 38, was told that the lump would be excised 
and biopsied.  If it was malignant, the surgeon would also remove her 
lymph nodes so that a pathologist could determine if the cancer had 
spread--a vital step in staging the cancer and plotting a course of 
treatment.

"As it turned out, Kastrup did have breast cancer.  All went according 
to plan--or so it seemed. Once she was home from the hospital, Kastrup 
called the surgeon's office several times, anxious to find out about 
her test results--and to learn of her breast cancer had spread.  Each 
time, she was told that the pathology report wasn't ready.  Then, 
about three weeks after the procedure, the surgeon called Kastrup into 
her office and confessed that the lymph nodes had never even made it 
to the lab.  In fact, they were lost.  'The surgeon was upset, so I 
told her not to worry, just to take some more,' Kastrup recalls.  To 
her horror, the surgeon explained that *all* the critical lymph nodes 
had been removed.

"Because the surgeon had removed all the cancer from Kastrup's breast, 
she didn't have a mastectomy.  Instead she underwent radiation and a 
six-month course of chemotherapy.  For two and a half years, she was 
fine.  Then, in early 1997, cancer was detected in her brain and 
lungs, and Kastrup underwent three grueling surgeries, intense brain 
radiation, and an additional 30 weeks of chemo.

"Today, as a result of two brain operations, Kastrup is partially 
blind in both of her eyes.  She can't walk without help, has seizures, 
and wears a wig to replicate the long, lush, curly hair she once had.  
and she is extremely weak.  'I can't work or cook,' Kastrup says, her 
voice barely audible.  'I can't get through the day without 
sleeping.'  

"Kastrup is suing Columbia Presbyterian Medical Center, charging the 
hospital with, among other things, failure to deliver her nodes to the 
lab and failure to outline her medical options after her nodes were 
lost.  She is convinced that early, aggressive treatment would have 
given her a better prognosis.  (Columbia Presbyterian Medical Center 
maintains that Kastrup was, in fact, treated aggressively.) When the 
Hospital lost her lymph nodes, Kastrup says, she lost her chance to 
fight the cancer as hard as she could.

"Another shocking lapse occurred just last December [2000: Julie] at 
the noted Hasbro Children's Hospital in Providence.  A young girl 
scheduled for eye surgery instead had her tonsils and adenoids removed 
and tubes put in her ears.  The reason?  A disastrous and completely 
avoidable mix-up.  Two young girls, close in age with similar first 
names, were waiting for their operations; when a staff member called 
for the girl who needed the tonsillectomy, the wrong child stood up.  
Apparently no one--not even in the operating room--checked the name on 
the patient's wristband.  Indeed, the mix-up was discovered only when 
a staffer came for the girl who was suppose to have eye surgery--and 
couldn't find her.

"AN EPIDEMIC OF ERRORS
"Lost test results.  Surgery on the wrong person-or body part.  
Misread lab results.  Misdiagnoses.  Medication mix-ups.  Every day 
mistakes like these occur in hospitals, outpatient clinics, and 
doctors' offices across the country.

"In November 1999, the Institute of Medicine (IOM), a division of the 
National Academy of Sciences, issued a report estimating that as many 
as 98,000 Americans die each year as the result of mistakes by health-
care providers.  Hundreds of thousands more suffer serious injuries.  
The total cost of these preventable errors: between $17 billion and 
$29 billion.

"Two new studies indicate that the problem may be even more serious.  
At one urban teaching hospital, researchers with unprecidented access 
listened in on what doctors, nurses, and residents actually said to 
one another about medical "accidents."  The findings, reported by Lori 
B. Andrews, J.D., a professor at the Chicago-Kent College of Law;  a 
medical mistake rate nearly five times as high as the IOM estimate.

"And since June 1997, when the Department of Veterans Affairs began 
requiring that medical errors at VA hospitals be monitored, the number 
of reported deaths and injuries has soared: nearly 3,000 mistakes in 
nearly 19 months, resulting in more than 700 deaths.

"Yet many errors never come to light.  Even if a patient or a 
patient's family files a civil suit for medical malpractice or 
wrongful death, it doesn't necessarily mean the error will be 
disclosed.  Many suits are settled out of court--which keeps the story 
far from the public eye.

"SEARCHING FOR REASONS
"Why do medical mistakes happen?  Economic factors probably play a 
role.  Currently [as of April 2001:Julie], one hospital in three is 
losing money--a 16 percent jump in five years--according to the 
American Hospital Association.  And lack of money can lead to 
potentially dangerous staff shortages or overworked personnel.  Newly 
minted residents may end up performing complex procedures without 
adequate supervision.  Or basic tasks--such as the trasnfer of lymph 
nodes to a lab may not get done at all.

"But the heart of the problem, according to one expert, is a poorly 
designed system.  'What we haven't done with health care is build in 
the safeguards that exist in other complex industries, such as 
aviation or nuclear power,' says Kenneth W. Kizer, M.D., president of 
the National Quality Forum, a nonprofit agency charged with developing 
a strategy for improving health care.

"Safeguards, Dr. Kizer maintains, should range from the simple to the 
high-tech--from a call-back procedure in which, say, a nurse verbally 
repeats a doctor's order to a computerized order-entry system for 
medication, which eliminates illegible doctor handwriting, a major 
source or drug errors.

"CHANGE IS COMING
"Help is on the way thanks to government and corporate programs.  The 
federal Agency for Healthcare Research and Quality in Rockville, 
Maryland, recently received $50 million from Congress to investigate 
and impliment safer health care.  A group of Fortune 500 companies has 
banded together to encourage employers to patronize insurers whose 
hospitals and doctors meet specific safety criteria.  And, at the 
grassroots level, people whose lives have forever changed because of 
medical errors have become advocates for patient safety.  After 
Patricia McEachern of Tampa was left partially paralyzed by a botched 
angiogrom [details posted later in this item:Julie], she and her 
husband, Ray, established the Association for Responsible Medicine ( 
http://www.a-r-m-.org ), which fights to protect the patient's right 
to safe, informed medical care.

"Change is coming.  'We're really beginning to rethink our whole 
approach to errors,' Dr Kizer says. 'But there is a long way to go.'  
Sadly, change, when it happens, won't help Laurie kastrup and others 
like her.  'I'm not bitter,' Kastrup says now, 'I feel I should enjoy 
everyday because I have no idea how many days there will be.  But what 
happened to me is atrocious.  I don't want to see it happen to anybody 
else.'"
--------------->
These strategies can help reduce the likelihood that you'll be the 
victim of a medical error.

In general

Call for test results within a week, advises Joanne Turnbull, Ph.D., 
executive director of the National Patient Safety Foundation. Lost 
diagnostic tests are common, so don't assume that because your doctor 
hasn't phoned, everything is okay. Many tests, including Pap smears 
and blood work, can be repeated. 

Get a second or third opinion if you need surgery or treatment for a 
new and potentially serious illness. 

Check the background of any new doctor you see. Find out where he or 
she trained and for how long and if he or she has a malpractice 
record. In some states, malpractice settlement information is posted 
on the Internet. In other states, it may be available in the county 
courthouse. The Agency for Healthcare Research and Quality (AHRQ) is 
working to improve methods for identifying doctors and nurses who may 
need close supervision. 

If you need to be hospitalized 

Choose a high-volume hospital. A study in the Journal of the American 
Medical Association confirms that there's a much greater chance of 
error if a new or high-tech surgical procedure is done at a hospital 
that doesn't perform it frequently. 

Make sure your hospital is accredited by the Joint Commission on 
Accreditation of Healthcare Organizations, which sets standards for 
hospitals and patient care. Check out your hospital at 
http://www.jcaho.org , or call the JCAHO at (630) 792-5800. 

If you are in the hospital 

Keep track of your medications. Computerized medication-entry systems 
have been developed, but fewer than 2 percent of hospitals require 
physicians to use them. Check with the nurse each time a medicine is 
brought to you or designate a friend or family member to do it for 
you. Question any change in medication or dosage; if you don't receive 
a satisfactory answer, don't take the medicine until you can check 
with your doctor. If you have a drug allergy, hang a large sign over 
your bed that reads, DO NOT GIVE ME _____. Just because it's written 
on your chart doesn't mean you won't get it. 

Make sure your provider wears gloves before handling your catheter or 
IV and cleans his or her hands before coming in contact with you, says 
Julie Gerberding, M.D., director of the Division of Healthcare Quality 
Promotion at the U.S. Centers for Disease Control and Prevention. 
Ask your provider if you really need a catheter. Bladder catheters are 
the main cause of hospital infections. Although initially sterile, 
they pass through nonsterile parts of the body during insertion. And 
the longer they stay in, the greater a patient's risk. 

If you need surgery 

Ask who will oversee any resident who will be performing an 
operation. "A reputable physician or surgeon should be present and 
immediately available," says the AHRQ's director, John Eisenberg, M.D. 
Make sure your surgeon knows which operation you're scheduled for. The 
American Academy of Orthopedic Surgeons asks members to "autograph" 
the limb or area they're going to operate on before the patient 
undergoes anesthesia. Obviously, this method won't work for every 
surgery, so always review your procedure with the doctor or surgical 
nurse.

[this last is from that link I posted earlier: Julie]
---------------------->
Any comments?  I will be occasionally posting details on 5 other 
stories mentioned in the magazine.  Any other stories that you have 
heard of, or discovered online or where ever, should be posted here as 
well.

11 responses total.

I tried to find a way to fit a shorter link in but was unable to do so.

use the following link instead

http://magazines.ivillage.com/goodhousekeeping

then go to the search area and type in "Medical Mistakes".  They will 
give you a list of possible hits.  You want the first one.

Question:  "Each year some 98,000 people die as a result of medical errors."
I must assume that this number is worldwide, since it is not specified, and
also since logic suggests that if this were a national number, the AMA,
congress, and/or the malpractice insurance industry would be locking horns
over an issue of significant impact.  Since that doesn't seem to be the case,
I would suggest that though the example cases MIGHT be truly represented, the
actual frequency of such incidences is low enough that the only real
conclusion is that the magazine, like most mainstream media sources, is
engaging in hype to improve its delivery of eyeballs to its advertisers.

Actually it is a big problem and they are working on ways to decrease it.

It's a big enough problem that people are dying because of it.  I 
don't care about the statistics.

The concern I have is that the measures being taken to correct the 
problem are appropriate to the extent of the problem.  I am not 
suggesting that there is a threshold number of people dying because of 
botched medical practices below which it cannot justifiably be considered 
a problem.  What I'm saying is that that number seems overwhelmingly high 
to be an accurate and truthful representation of the scope of this 
problem in the United States, and that what I think should NOT happen is 
exactly what will happen as a result of hyping such issues in order to 
boost circulation numbers; there will be a clamor for a legislative 
action which will ultimately be nothing more than a band-aid, but which 
will have predictable side-effects vastly more far-reaching than the 
actual problem itself.

        Moreover, if there's a statistic that begs to be elaborated on, then
that statistic is it.  Are medical errors such as inappropriate treatment of
a fatal - but rare - disease included?  Or, perhaps, proper but overly
conservative treatment of a more common or easier to diagnose disease?

i think i need to re-start smoking cigarettes- fsck!

Please remember that this issue is a year old.

For what it's worth, while losing biopsies is clearly a serious problem, it
sounds to me that the woman in the first example would not be any better off
if they had been maintained.  What she went through sounds an awful lot like
what my dad went through, and he was clean after his first chemo.  Cancer
comes back occasionally, it's not always somebody's fault.

Errors are going to happen.  I think it's a problem, but it's hardly a new
epidemic.

A RAPID DRUG OVERDOSE~
When 16-year-old Katie Tyra needed a cyst removed from her neck, her 
father, a now retired US Marine colonel, and mother chose the 
prestigious Walter Reed Army Medical Center in Washington DC.

But, in the operating room, on April 8, 1998, the unthinkable 
happened: Captain Michael Hamner, MD, then a third-year anesthesiology 
resident gave the teenager a rapid dose of a presurgery antibiotic, 
which is typically administered more slowly.  When Katie's heart-rate 
sped up and her blood pressure plummeted, Dr. Hamner gave her another 
medication in an attempt to stabilize her before summoning the 
supervising anesthesiologist.  In his follow-up report, Dr. Hamner 
failed to explain why he had "pushed" the antibiotic.

Katie died 13 days later.  Eventually, Dr. Hamner admitted that he had 
falsified the report.  He was scheduled to stand trial by court-
martial for involuntary manslaughter in January [2001], but the trial 
was postponed pending further investigation.  Katies mother has filed 
a civil wrongful-death suit against the federal government for $10 
million.

"The concern I have is that the measures being taken to correct the
 problem are appropriate to the extent of the problem."

Gee, so we really do agree on something here!  That's what I've been
saying about gun laws for the longest time now.

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