Hearst project looks at toll of medical mistakes
Filed under: Health journalism, Hot Health Headline
A team of reporters from Hearst news organizations across the country contributed to “Dead by Mistake,” a broad investigation into deaths caused by “preventable medical injuries,” of which the reporters estimate there are almost “200,000 per year in the United States.” A decade after a federal report challenged the medical community to halve the accidental death rate, the toll taken by medical mistakes has instead increased even further, the Hearst reporters found. Furthermore, reporters found that “the medical community, the federal government and most states have overwhelmingly failed to take the effective steps outlined in the report a decade ago.”
According to the report, the American Medical Association and American Hospital Association are partly to blame, as they have opposed any mandatory reporting of medical accident. Even in the 20 states that have implemented mandatory reporting rules, research indicates that only a small fraction of accidents are actually reported. Despite this “chaotic, dysfunctional patchwork,” the Obama administration is not supporting national mandatory reporting.
Cathleen Crowley and Eric Nalder’s centerpiece, which focuses on hospital reporting of mistakes, is an informative read for anyone interested in the availability of hospital safety data on national and local levels, both now and in the future.
The package as a whole includes local stories for Hearst markets including California, Texas, Washington, Connecticut and New York as well as a number of in-depth anecdotes and stories with a national scope.
Editor Phil Bronstein explains how the project was reported, including compiling and analyzing nine databases and conducting hundreds of interviews. The cross-platform project involved journalists from print, television reporters and the Web. BayNewser has a Q&A with Bronstein about how the project was done.
Philly VA botched 92 of 116 cancer treatments
Walt Bogdanich of The New York Times uncovered an astounding series of regulatory and oversight errors that allowed a “rogue” cancer unit operate with impunity at the Veterans Affairs Medical Center in Philadelphia.
Bogdanich reports that its doctors, primarily Dr. Gary Kao, had botched 92 of 116 cancer treatments in more than six years. The unit treated prostate cancer with radioactive implants, a process known as brachytherapy. Doctors in the unit avoided regulation in part by revising surgical plans to cover for mistakes.
The first clear signs of trouble cropped up in early 2003, the unit was suspended in 2008. Here’s a brief catalog of missed opportunities to reign in Johns Hopkins-trained Kao and associates:
- The unit did not have any peer review process in place.
- The V.A.’s radiation safety program didn’t intervene.
- Neither did the Joint Commission, the group that accredited the hospital.
- Doctors in the radiation implant program weren’t properly supervised.
- Or “trained in what constitutes a substandard implant and the need to report it.”
- Errors went unreported for months, or even years, while patients had no idea they were even made.
The whole house of cards only came tumbling down when a mistaken purchase of lower-radiation implants triggered an investigation of previous cases. Investigators didn’t find any lower-radiation implants, but they did find errors. Lots of them.
No patients are believed to have died from this mistake-riddled treatment; the unit was suspended in mid-2008 and similar programs (whose problems don’t seem to have been as severe) were shuttered in Jackson, Miss., and Cincinnati. Seven of the affected patients were flown to a more experienced V.A. unit for additional treatment.
Update
In a related story, The Philadelphia Inquirer reports that the problems came to light “not because the NRC finished its inquiry” but rather when a Nuclear Regulatory Commission advisory committee asked the agency for an update because “committee members had been hearing disturbing things about the Philadelphia VA’s program.”
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The AHCJ-NLM Fellowships will give four journalists the chance to spend a week on the campus of the National Institutes of Health learning about research and data from NIH and NLM, biomedical statistics, programs and resources and get hands-on training. Applications due Aug. 2.
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