Editorial: Medical mistakes take a toll

Thursday, Dec. 2, 1999 | 9:38 a.m.

The numbers are startling. In a report released Monday the Institute of Medicine estimates that at least 44,000 hospital patients, and possibly as many as 98,000, die annually from medical mistakes. To put this into perspective, medical mistakes are the eighth leading cause of death, ranking ahead of highway accidents, breast cancer and AIDS. The institute's report, which was commissioned by the National Academy of Sciences, made a series of proposals in an effort to reduce medical mistakes by 50 percent within five years. The possible fixes range from simple procedures that can be addressed by hospitals and doctors themselves to more sweeping recommendations that would require action by Congress.

Some of the mistakes occur in basic, everyday tasks. For instance, the handwriting on prescriptions prepared by doctors sometimes is illegible, resulting in either the wrong drug being filled or the incorrect dose being given. Medication errors alone result in more than 7,000 deaths a year, but this doesn't have to be the case, as the Institute of Medicine notes. Computerizing the filling of prescriptions can reduce these errors, eliminating the guesswork of a pharmacist trying to make out the handwriting. Another problem involved with prescriptions is that some have very similar spellings and pronunciations. For instance, Cerebyx is an anti-seizure drug while Celebrex is a painkiller. The institute recommends that the Food and Drug Administration, which regulates prescription drugs, should get rid of similar-sounding drug names and confusing packaging tha t can result in deadly errors.

This is more than just about correctly filling prescriptions, though. The Institute of Medicine believes a significant commitment must be made in every facet of health care. The institute is advocating that Congress establish a federal center for patient safety that would establish national safety goals and track the progress in achieving them. In addition, the report found that hospital and other health care groups should be required to report serious mistakes to state licensing boards so they can chart problems and take action if necessary. The "culture of secrecy" that currently exists leads to doctors not discussing their mistakes. One of the difficulties, admittedly, is legal liability. "We may know to talk about a culture of safety, but we still live in an environment of blame," Dr. Nancy Dickey, past president of the American Medical Association, to ld the Associated Press.

The authors of the report believe that pressure from all directions -- including workers and employers that provide health care for their employees -- will be required if safety is to be realized. They're right. Another hurdle will be getting the Republican-led Congress to take the issue seriously. Last year Congress failed to pass a patient's bill of rights and was unable to seriously address the separate issue of how to get insurance for those Americans unable to afford private health care coverage. Congress has an opportunity to finally improve the quality of health care in this nation. For the sake of patients everywhere, lawmakers shouldn't scuttle this opportunity, too.