In spite of efforts to minimize medical errors, patients who undergo surgery are often subjected to the most blatant and outrageous surgical errors, including surgery on the wrong site or even surgery on the wrong patient.  According to a new study, there has been little progress in minimizing these serious errors.  In 2004, a Joint Commission introduced a universal protocol that all hospitals and ambulatory care facilities are expected to follow.  In spite of this, Arizona medical malpractice lawyers have been concerned to find that these errors continue to occur at an alarming frequency.

The results of the study are published in the October issue of the Archives of Surgery.  Researchers analyzed data on surgical errors in Colorado.  In the database, doctors reported a total of 27,370 adverse events that occurred between January 2002 and June 2008.  Out of these, the researchers identified at least 25 wrong patient surgeries and 107 cases where the operation was performed on the wrong site.  Five patients, who received unnecessary surgery, received significant harm.  38 persons, who received surgery on the wrong site of the body, were also significantly harmed.  One person who had a wrong site procedure died from his injuries.

The researchers then looked at the reasons for these errors.  They found that diagnostic errors were involved in 56% of the wrong patient operations.  They also found that 100% of these wrong patient operations occurred because of poor communication.

Among wrong site surgeries, the researchers found that 85% occurred due to errors in judgment.  72% occurred because of failure of doctors and healthcare professionals to perform a timeout as the universal protocol demands.  During a timeout, the doctors, nurses and other healthcare professionals in the operating room check that they have all the basics in place - that the patient is the one that needs the surgery, and the part that is marked for surgery is the right site. 

Orthopedic specialists seem to be involved in the most number of wrong site surgeries at 22.4%, followed by 16.8% wrong site surgeries in case of general surgeons and 12.1% in the case of anesthesiologists.  Internal medicine specialists were involved in 24% of all wrong patient surgeries.

The survey was conducted by researchers at the Mountain Institute for Health Policy at Massachusetts General Hospital, and included a total of 1,891 doctors in various specialties. The results of the survey have been published in JAMA. According to the survey,

• 69% of respondents felt they were equipped to deal with a colleague who was impaired.
• An approximate 64% of respondents reported that they believed they were equipped to deal with an incompetent colleague.
• 17% of respondents said they had had personal knowledge of an incompetent physician, and out of this, 67% said that they reported that physician or colleague.

The American Medical Association requires that doctors and physicians report intoxicated, impaired, unethical or incompetent doctors. The results of the survey show that far too many doctors don't seem to believe that this very necessary.

So, why would a doctor just look the other way when he sees a colleague significantly impaired? The answers are complex. Sometimes, physicians believe that reporting the doctor wouldn't actually make a difference to the situation, and other times, there is a fear of retribution from the intoxicated or incompetent doctor. That's confirmed by one fact in the study, which showed that doctors who were part of a one or two-person practice, belonged to a racial minority, or who graduated from non-American medical schools, were less likely to report intoxicated or incompetent colleagues, than doctors at hospitals or medical schools. There are also likely some feelings of empathy for the intoxicated doctor. It's also possible that doctors fear being sued by the physician they report.

Ultimately, patient safety is not about what's best for the doctors, but what's best for the patient. Doctors have a moral obligation to make it known when one of their colleagues is not in a position to discharge his duties safely. As Arizona medical malpractice lawyers know, failure to do so can be catastrophic, and the medical community needs to examine this issue.