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Wrong-Site Surgery - Does anyone see the bigger picture of what is wrong with the system?

By Steve Lombardi

Before going on to the next part in this series about wrong-site, wrong-patient or wrong-procedure, we need address the question: Why write about this subject? Why is this, a topic of discussion that has the lawyers' interest for an entire month?

Our answer is pretty simple: No one seems to be seeing the bigger picture that improves patient safety. The doctors and hospitals aren't talking about it and don't report it when it happens. They are all still billing you and I when it happens.

In my twenty-seven years as a civil trial lawyer, I have had three, yes three clients with this type of insult that they did nothing to deserve. Two are women whose reproductive organs were improperly altered by unauthorized surgery. And I don't want you thinking this is a problem the lawyers are creating. No way. I want you to know its real, not a figment of a lawyer's imagination. And to prove it I want you to read another post from yesterday that discusses a wrong-site surgery two days ago in Texas. And then read Jane's post about four incidents of brain surgery in Rhode Island. Yes brains. Plural.

You need proof? Let me give it to you. Beth Janicek from San Antonio writes today about this subject; her titled post is "Surgery Gone Wrong". In a well written post she describes how just yesterday, yes just yesterday it was reported in a San Antonio news report.

"There was a story this morning on a local San Antonio news station discussing Janie Garza, a poor woman who went into Methodist Ambulatory Hospital for arthroscopic surgery for a tear in her left knee.

Everything seemed to be going well - she was sedated, her leg was prepped and surgery began. When she woke up the doctors even told her everything went great. She then realized things did not go so great. The doctors operated on the wrong knee -- her GOOD knee. She notified the doctors and they took her back into surgery and operated on the knee that was torn."

If you think this can't happen to you then you're naïve. If you believe this is something the doctors aren't responsible for, then you're fooling yourself. You see not placing responsibility for what goes wrong in a wrong-site surgery will only encourage it. Paying the system for doing it wrong when it wasn't consented to does nothing to discourage those bad habits that are allowing it to happen. Jeff Rasansky of Dallas, Texas writes about how the health insurance system is finally catching up with the common sense of business when he reports on how BCBS is now, finally, refusing to charge the patient or agree to pay for the unauthorized and unnecessary surgery. Yes, correct the system paid them for doing the wrong surgery on a healthy part of the patient's body. For real, I'm not making this up.

"Hospitals around the country have come together to say they will no longer bill patients for their medical mistakes. Tennessee is one state out of 23 that has approved the non-payment policies for mistakes, with at least three more expected to follow suit.

The remaining 24 states have yet to implement this policy. This leaves many of the patients and family members who have run into this problem stunned. 67-year old Blake Oliver died last year in a Florida hospital after they mistakenly gave him type A positive blood instead of type O during a transfusion.

His sister is irate.

"With something this horrific, whether they've operated on the wrong person or removed the wrong finger, they shouldn't expect reimbursement," she said."

And why has this gone on for so long? Why does the system make excuses for those who allow themselves to act in such a grossly negligent and unprofessional manner? Well, studies have been done on this subject and at our National Desk Jane Akre wrote Rhode Island Hospital Reprimanded for Wrong Site Surgeries. I hate it to seem like I'm picking on Rhode Island Hospitals because I was born in the one seen on the opening shots of the TV show Providence. What the heck they brought me into this world, but come one, four wrong-site brain surgeries? What's that about? Someone juice up the caffeine in the morning coffee. Let's get these guys awake and learning left versus right. My four-year old Granddaughter Mariah might be able to help with left versus right. It seems almost facetious to suggest to patients they ask the surgeon to point to the patient's left or right side, but four wrong-site surgeries in six short years? I would if it were my brain. Maybe they could paint left and right on the operating table depending on whether the patient is prone or over-easy.

"The hospital reports a resident in training began drilling the right side of the patient's head even though the bleeding was on the left side. After realizing the error, the hospital reports it took one stitch to close the initial surgery and then the team proceeded correctly on the left side.

The patient is reported to be okay.

A different doctor at the same hospital performed brain surgery on the wrong side of another patient's head in February. Then in August, a patient died after a third doctor operated on the wrong side of his head.

Friday's is the fourth "wrong-site surgery," as it's called, at this hospital in six years."

Lawyers who practice in the area of medical malpractice talk about the "conspiracy of silence". It's the concept that few if any medical malpractice actions can proceed without a medical expert to prove the injured patient's legal case. So if no one will testify the negligent doctor skates out the court house door freed from being held legally responsible for their actions. So if you think this is a legal problem you're wrong it's a medical problem being exacerbated by a bad business model.

So here we go with what medical students are taught. Here is a video by a first year medical student who's being taught about how to avoid the wrong-site surgery and he says if it happens it's no one's fault. Well, whose fault is it if the local garage mechanic installs brakes on the wrong car? Of if I file a lawsuit in the wrong county? Or if the electrician hooks up the wires to the wrong site, the shower pipe and you get electrocuted? Is that also no ones fault?

This first year medical student is being taught that when a surgery is performed on the wrong-site, wrong-patient or the wrong procedure, that its nobodies fault. Why are medical schools teaching our student doctors they are not legally responsible for medical errors? How is that responsible medicine? It isn't and should not be a part of the curriculum.

You be the judge. Like the commercial says, "This is your brain on meth." Hear the sizzle..

Tomorrow we'll pick back up with the next part in this series. ©

Originally posted at InjuryBoard by Steve Lombardi

Full post as published by Des Moines Personal Injury Lawyer on August 14, 2008 (boomark / email).