Talk:Medical error

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Contents 1 Ballpark figures not very helpful 2 Ball park figures & the Institute of Medicine Report 3 Medical Narcissism 4 Merge proposal

[edit] Ballpark figures not very helpful

Think of a number and double it? The first sentence of this article is one of the worst I have seen in Wkipedia, namely "In the United States medical error results in 44 000-98 000 unnecessary deaths each year...." What? Doesn't anyone actually have even a reasonable estimate? The 98,000 figure is 222 per cent higher that the 44,000 figure. We are saying that in 1990 (example) there were between 44 000 and 98 000 unnecessary deaths, and in 1981 there were between 44 000 and 98 000 unnecessary deaths. How can we exect Wikipedia to be taken seriously with such ballpark figures. Moriori (Sorry, forgot to sign).

dude. check the ref. Erich 04:20, 12 Jun 2004 (UTC)

There are no exact numbers on this because the numbers I have seen are all estimates based on extrapolations. That's right - the data is not good. And that the data is no good is even more alarming! Kd4ttc 19:19, 12 Jun 2004 (UTC)

I am astonished that User:Erich gasboy, a doctor, would defend a single set of data taken selectively from the tonnes of verbiage available through google. I wonder what he would say if I amended the intro to about 20,000 and gave [1] as the authority. Here's a quote from it -- the Institute of Medicine estimates that over 100,000 patients die every year in U.S. hospitals as a result of medical errors or mistakes…. and beginning in 1999 that dialogue was sold to the American public in newspaper banners and on TV news programs across the nation. However, the important story is that 80% or 80,000 of those 100,000 patients die from an infectious disease. This fact – published by the CDC – was noted in earlier reports in 1999, but seldom mentioned when reported on in recent years. The 80,000 who die from infectious diseases are conveniently ‘bundled in’ with the other 20,000, most of whom did die because of medical errors. I believe our current article is demonstrably lacking in integrity and is doing Wikipedia a great disservice.Moriori 23:59, Jun 12, 2004 (UTC)

Regarding the infections - these are largely preventable deaths themselves. Ventilator associated pneumonia and catheter related infections are examples of infections that are usually caused by poor systems (errors) in place that do not take the necessary steps to prevent such infections. --Jrmunch 04:46, 20 March 2006 (UTC)

Everyone in the hospital dies of an infectious disease. Well, a few die of cardiac arrest, but vastly more die of infectious diseases. A person allergic to penicillin falls and breaks a bone--far from a lethal injury. Goes to hospital, where broken bone is set by orthopaedic surgeon. Suffers anaphylactic reaction to penicillin-class antibiotic because his surgeon forgot to ask about medicine allergies. Gets intubated and sent to the ICU for anaphylaxis. Once in the ICU develops a pneumonia with a multidrug resistant organism. Dies with sepsis 3 days later. Death due to infectious disease or prescribing error? --Matdaddy 01:59, 4 Mar 2005 (UTC)

I prefer to quote peer-reviewed academic journals rather than anonymous web-sources.

Then quote them. You used [2] as a reference for the United States medical error results in 44 000-98 000 unnecessary deaths each year. That reference says no such thing. Moriori

oops that abstract does not give those figure - give me a mo and I'll find and online reference to those stats.Erich 04:34, 13 Jun 2004 (UTC)

Listen, feel free to improve the article if you like. This is a draft article on an important topic. I am a bit stunned by your comments "demonstrably lacking in integrity " and "doing Wikipedia a great disservice". Your reference goes on to clarify that the 80000 infections are also due to error. I've had a look at your contribs to try to understand your perspective, but still stunned really. Anyway if you like please have a look at the quoted refs from the peer-reviewed academic journals and feel free to help us knock of the rough edges of this article. cheers Erich 00:20, 13 Jun 2004 (UTC)

OK, fine. Can you say why a comparison to aviation is relevant?

aviation has an admired saftey culture and often put forward as what health should model itself on. this view does have critics.

The nuclear power industry is also often used as an example of a model of safety. The main point being that these industries have realized that human do make errors, and that the way to prevent them is to use good systems with redundancy that minimize the chance of an error happening or minimize its significance should it happen. --Jrmunch 04:52, 20 March 2006 (UTC)

Should carelessness be added to the section headed "Epidemiology of medical error"?

well that is consistent with the 'blame approach' to error [3]. fatigue, inexperience, overwork, inadequate supervision and lack of training are probably far more common than 'carelessness' though. personally I'm not keen to add carelessness but won't delete it if you add it, as I'm sure as humans we don't maintain 100% care at all times.

What exactly is meant by the following -- while error rates are reduced, the errors just become less likely .

geezz dunno... Steve?

Ideally the likelyhood is so low that the errors are extreemly unlikely?

well 'ideally' agreed. in reality errors happen all the time.

Can I have a go at the encyclopedic nature of this story, and you ensure the efficacy of the medical input? Moriori 01:52, Jun 13, 2004 (UTC)

please do! careful tho - the nuance can be subtle and this is a complex area. I'll work on added a few more refs and try to highlight the ones that it would pay you to look at. (apologies again for the misleading link above).. and if you think I get touchy... you haven't seen Steve stirred up ;-) Erich 04:34, 13 Jun 2004 (UTC)

I have to admit that I agree with person complaining that the avation comparison is irrelevant. What pilot ever jumps on a plane that is already crashing toward the ground, then given the blame when it hits the ground. —The preceding unsigned comment was added by 69.221.131.218 (talk • contribs).

Much of the error prevention terminology and early research was developed by the aviation industry. The basic design is the same in aviation and medicine: a complex system with a lot of moving parts, and a human-technology interface. And the consequences of error are death or severe injury. Analytic methods such as root cause analysis and failure mode effects, and concepts such as standardization, process design and team training reduced errors in aviation and are being tried in medical error reduction now. So I think it has a lot to do with it. -- Ryanjo 03:26, 20 June 2006 (UTC)

[edit] Ball park figures & the Institute of Medicine Report

I added a link to the first paragraph of the article (reference #1) for the on-line version of the 2000 Institute of Medicine report, To Err is Human. This report led to the media quoting the 44,000 to 98,000 deaths yearly. As the Executive Summary section report, this was based on two studies (one in Utah and Colorado and one from New York) which were extrapolated to estimate total US mortality by multiplying by the number of hospital admissions. Unfortunately, the links to the references are dead, so we can't examine these studies themselves. (It might be possible to find them elsewhere; I'll try). In any case, the wide range of these estimates derives from the math; two different studies, and amplifying the data to millions of hospitalizations. Not that the point is diminished; a single avoidable death is a tragedy. -- Ryanjo 20:59, 20 June 2006 (UTC)

[edit] Medical Narcissism

I have inserted book by Banya. Medical narcissism is an area that needs to be covered.--Penbat 08:34, 6 October 2006 (UTC)

[edit] Merge proposal

This article should be merged with medical malpractice. Comments? -- FP ^{(talk)(edits)} 10:25, 18 November 2006 (UTC)

Oppose-This article covers the cause and correction of medical error. As I read the medical malpractice article, it covers the legal aspects (mostly). The distinction is useful. I have added a link to this article in medical malpractice, and vice versa. Ryanjo 15:44, 19 November 2006 (UTC)

OK, it looks like there is no interest in merging so I will leave the articles separate. -- FP ^{(talk)(edits)} 04:23, 25 November 2006 (UTC)