Wednesday, June 30, 2010

Las Vegas' Skyrocketing Medical Errors Just Part of Private Sector Self Policing

Who needs health care reform, when you have the free market watchdogging itself?

So how well has lax oversight and unusable data worked in the private sector to reduce medical errors, the reason for all malpractice lawsuits. Not well. You would think that reducing patient harm would reduce, on the other end, the problematic lawsuits conservatives complain so much about.

The Las Vegas Sun’s investigation of Nevada hospital data shows 969 incidents of inpatient injuries — some that can be deadly … Rosie Powell’s surgeon removed a mass from the 74-year-old’s abdomen, thinking it was a cancerous tumor. It was a healthy kidney … Donna Wendt’s windpipe was torn during insertion of a breathing tube. Oxygen was pumped into her chest cavity instead of her lungs, bloating her. She couldn’t be saved.

Over a two-year period — 2008 and 2009 — patients suffered preventable injuries,
life-threatening infections or other harm 969 times during their stays in Las Vegas hospitals, an exhaustive Las Vegas Sun investigation has found … Until now, neither the scale of avoidable incidents nor the hospitals where the harm occurred have been publicly known, in part because hospital lobbyists have resisted the state’s efforts to make the information more public … The information gleaned from 425,000 inpatient visits tells a story of preventable harm, deadly infections and possible neglect — at a rate of about one injury per day.

it appears the hospitals are failing to report many incidents … 21 cases in which hospital patients accidentally had foreign objects left in their bodies after surgery … 79 cases in which a hospital patient developed an advanced-stage pressure sore … 475 cases of bloodstream infections involving central-line catheters — flexible tubes implanted into main veins to quickly introduce medications … 248 cases in which hospital patients suffered postoperative falls or other trauma. The data show 79 instances in the 13 area acute-care hospitals where the harmed patient died.

The numbers beg for comparison with other regions … In October 2008, Medicare stopped reimbursing hospitals for preventable “hospital-acquired conditions,” another name for the events identified by the Sun. Medicare’s move addressed the perverse incentive facilities have to not correct harm done to patients: Most insurance companies pay them to treat the hospital-acquired conditions. The injuries can be moneymakers.

Bill Welch, president of the Nevada Hospital Association, questioned whether medical error reporting was worth the cost. No study shows that mandatory reporting measurably reduces the errors, he said. The 1,363 incidents of statewide hospital-acquired harm identified by the Sun from the 2008 and 2009 data seem to fit Nevada’s definition … Yet during that period Nevada hospitals reported only 402 sentinel events.

Regulators have trusted the hospitals to do what’s best for patients.

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