Ten Tips on Reducing Your Chances of Becoming a Victim of Medical Error
Tips from Michael J. Saks & Stephan Landsman, authors of the new book Closing Death’s Door (Oxford University Press 2021)
Before going into the hospital:
1. Get a second opinion. Avoid, if possible, being rushed into invasive procedures that could wait for a second opinion. Neil Armstrong, the first human to set foot on the Moon, likely died from being rushed into a coronary bypass procedure that was not handled well, and which could have been more carefully considered with a second opinion, and a more thoughtful choice of surgeon and hospital.
2. Check on the safety record of the hospital you will be treated in by consulting online ratings. Centers for Medicare and Medicaid Services or The Leapfrog Group are some of the most reputable sites for ratings. Make sure the hospital is accredited by The Joint Commission (qualitycheck.org). Some states post their own hospital ratings; if available, check those, too. (But be cautious about ratings by patients of their doctors. Research has found little correlation between patients’ ratings of doctors and serious problems those doctors have gotten into. Bedside manner carries too much weight with too many of us.)
3. Make sure the procedure your surgeon is going to perform is one that she or he has done many, many times before and continues to perform frequently. Research has found that, for most procedures, the best outcomes and fewest complications arise when the surgeon performing the procedure has considerable experience with the procedure and maintains a schedule of frequently performing it. Some hospitals have even “taken the volume pledge,” that is, they allow only surgeons who perform a certain minimum number of high-risk surgical procedures to continue performing those procedures.
In the hospital:
4. When you are going to be in the hospital, try to have a close friend or family member be with you as much as possible – as your advocate, your eyes and ears, your brain, to watch what is happening, to ask questions, to take notes. Obviously, you, the patient, might not be at your sharpest when you are needing medical care. You and your advocate should pay close attention to changes in your condition (pain, fever, thirst, dizziness, etc.) and ask about them. Be alert to the danger of falls, which can happen so easily and cause serious harm. Don’t be shy. Don’t suffer in silence. Moreover, good healthcare organizations encourage patients (and family or friends) to ask questions and to speak up if they see something that concerns them.
5. You can avoid medication errors by asking hospital staff what you’re taking, how much, how often, and why. Armed with that information, you have a chance of catching discrepancies when someone from your medical team comes in to administer drugs and to make sure that the right drug and right dose are delivered to the right patient.
6. On any given day, about 1 in every 25 hospital patients contracts an infection. The single easiest and most effective solution is to remind your clinician to wash his or her hands. It is also one of the most frequently skipped infection-prevention measures.
7. During your pre-op preparation, ask what procedure is to be performed on you – if someone from the care team has not already asked you. And make sure the correct arm, breast, brain hemisphere is clearly marked.
After you leave the hospital:
8. Be sure to follow instructions for after-hospital care. Nurses usually give detailed packets to patients as the time of discharge approaches, that you have or have arranged for any medications you will need, and that you have contact information for whom to get in touch if complications arise. Particularly at home, patients should have a list of names and numbers available for immediate use in case of emergencies.
9. Lack of continuity of care can be a serious problem during the transition from the hospital to the next place of care. Problems can arise when care is handed off to a skilled nursing or rehabilitation facility, or anywhere. If your discharge is to your home, it is best to have someone who lives with you or can visit with you frequently (a visiting nurse, perhaps) who understands the post-discharge care instructions and has the skill to carry them out.
10. Opioids can be a very valuable pharmaceutical intervention. But they pose a serious risk of addiction and should be used only as prescribed and when necessary.
About the Authors
Professor Michael J. Saks
Michael J. Saks is Regents Professor at the Arizona State University, where he is on the faculties of the Sandra Day O’Connor College of Law, the Department of Psychology, and the Law and Behavioral Science Program, and is also a fellow in the Center for Law, Science, and Innovation. Previously, he was a faculty member at the University of Iowa as the Edward F. Howrey Professor of Law and Professor of Psychology. For a decade, he taught appellate judges in the University of Virginia Law School’s summer LL.M. program, trial judges in Duke University’s Judging Science program, law professors at the Georgetown University Law Center, and law students, graduate students, and/or undergraduates at Boston College, Georgetown, and Ohio State University, as well as at ASU and Iowa.
Michael’s research and scholarship have spanned a range of topics: the psychology of decision-making in the legal process, the behavior of the litigation system, scientific and other expert evidence in the law, and legal policy related to iatrogenic injury.
Michael has authored several books including, Modern Scientific Evidence: The Law and Science of Expert Testimony (five volumes), The Psychological Foundations of Evidence Law (2016) and Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm (2021).
Michael’s work has earned a number of awards and has been cited in various judicial opinions, including several by the United States Supreme Court. His articles have made a lasting impact on the legal system, in part because he tries to address the big picture. Thus, his piece on “The Behavior of the Tort Litigation System,” a landmark integrative review of empirical research concerning the litigation system, has been the most-cited article on tort law for more than a quarter-century. And, “The Coming Paradigm Shift in Forensic Identification Science,” in the journal Science, helped stimulate a groundbreaking examination by the (U.S.) National Research Council of the traditional forensic sciences.
He earned a Ph.D. in experimental social psychology from the Ohio State University and an M.S.L. from the Yale Law School.
About Professor Stephan Landsman
Professor Stephan Landsman is the Clifford Professor of Tort Law and Social Policy, Emeritus, at DePaul University College of Law in Chicago, Il. He is a graduate of Harvard Law School, the author of six books and more than 70 articles. His most recent books concern medical error, the challenge of crimes of the Holocaust, and the merits of the American adversary system of justice. He is an expert on the American jury. Stephan’s scholarly articles examine the history, value, and workings of the jury. He was the Reporter responsible for drafting the American Bar Association’s Principles for Juries and Jury Trials.
He successfully argued before the United States Supreme Court in Akron Center for Reproductive Health v. City of Akron and has pursued claims regarding medical malpractice, sex discrimination, judicial recusal, products liability and aviation accidents.
As a professor, Stephan has taught in England and India, and lectured in Japan, China, Australia, Israel and across the United States. He continues to work as a practicing lawyer, as he has throughout his career.