Causes of Medical Mistakes
When a medical mistake happens to a patient,
the question is always why did it happen.
In many cases, the issue is not one of
negligence by a doctor or other medical practitioner,
but rather a systemic issue.
On the other hand, there are many cases of malpractice
brought against medical practitioners, alleging
various levels of failings.
In any case, let us attempt to categorized
some of the possible causes of medical mistakes
Fundamental difficulties in medical care:
Providing health care is a difficult undertaking
and it is inevitable for some level of mistakes to occur.
- Inherent difficulty in balancing the need to double-check
to avoid diagnosis errors
with the need to avoid over-testing.
- Inherent impossibility of doctors, and even specialists,
of staying up-to-date
for every condition they face in their work.
- Inherent impossibility of doctors to give totally accurate
medical care when only a brief time is available for appointments
for each patient.
General medical industry system problems:
The medical industry overall contributes to higher than necessary
rates of medical mistakes.
Although some errors are unavoidable,
the industry could do much better.
- Under-funded medical care
- Inefficiency leading to poorly used funds
- Over-busy doctors and other medical staff
- Over-tired doctors from excessive time schedules
- Slow adoption of new technologies
- Failure to report medical errors for fear of lawsuits,
making errors hard to monitor and correct.
- Unnecessary medical tests to double and triple-check, from fear of lawsuits
Individual doctor mistakes:
Your doctor can obviously make a mistake in various ways.
- Simple human mistakes: everyone makes them, even the best doctors.
- Doctors who are drunk or on illicit drugs
- Poor handwriting: can lead to errors in filling prescriptions
or wrong hospital medications or tests.
- Poor dosage instructions: difficult to read numbers,
such as zeroes and decimal points, can lead to wrong dosages.
The patient can contribute to an error occurring in their health care.
Patients should view achieving good medical care as something
over which they have partial control.
- Failure to report symptoms: some patients do not tell the doctor about
all their symptoms for various reasons (embarrassment, thinking it will
be irrelevant, the doctor didn't specifically ask about it, etc.).
- Delay in reporting symptoms: this is a very common human tendency,
a form of denial that something is wrong.
- Failure to report other medications they are on, either prescription
or over-the-counter medications.
- Failure to report other alternative medicines they are taking
- Non-compliance with treatment plan or medications:
over-looked medications, financial troubles, laziness, etc.
- Dishonesty of patients: certain hypochondriac and factitious syndromes,
desire to obtain restricted drugs,
getting time off work, etc.
- Fear of legal issues: e.g. failure to admit to taking illicit drugs
- Fear of social issues: e.g. failure to admit to lifestyle
or social habits.
- Fear of doctor's scolding: e.g. failure to admit to not
- Patient pressure: the tendency to push the doctor for certain treatments,
such as antibiotics, sleeping pills, or behavioral drugs,
even when they may not be in the best interests of health.
This creates a conflict between the doctor's desire to give
correct medical care and keeping the patient happy.
- Failure to read medication labels and instructions fully
The dispensing of medications at the pharmacy can be the source
of various mistakes.
- Wrong medication dispensed
- Similarly labeled or packaged medications wrongly given.
- Similarly named medications confused (by doctor or pharmacist)
- Wrong dosage dispensed
- Failure to communicate instructions on taking medication
Pathology laboratory mistakes:
The various laboratory tests used for diagnosis (and sometimes treatment planning)
can have several types of errors:
- Errors in labeling samples: mix-ups in patient samples
- Cross-contamination during testing
- Inherent known risks in various tests (false positives, false negatives)
- Limitations of certain tests for certain patients
- Human error in examinating visual slides (e.g. cell biopsy, Pap smears)
Pharmaceutical industry mistakes:
The drug industry has contributed to certain medical mistakes such as:
- Naming similarities in medication brand names
- Inadequate safety testing of some drugs leading to drug withdrawal
The hospital is a large institution that can make numerous types of mistakes.
- Nosocomial infections: these are infections that are caught during a hospital stay,
either from the environment or from surgery or other treatments.
- Surgical mistakes
- Errors in transferring and re-labeling medicines into smaller containers
- Medication errors: wrong medication, wrong dosage, etc.
Any type of surgical procedure has various risks
and there are certain errors that can occur.
- Wrong patient surgery
- Wrong site surgery: e.g. surgery on the wrong organ.
- Failure to suspend other medications before/during/after surgery: e.g. deaths
from lactic acidosis due to Metformin usage in surgical recovery.