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Medical Mistakes


Medical Mistakes

Errors are inevitable in the practice of medicine, and preventing mistakes is most of the battle. Getting the best possible health care can be achieved through getting mistake-free diagnosis and mistake-free treatment.

All physicians make mistakes and most of them aren’t the result of negligence. Errors may result from many situations, such as a medicine’s inherent uncertainty or oversights on the part of the individual provider. But either way, a physician has to face situations where they must address mistakes with their patient.

 

On a physician’s part, they may commit an error due to an error in perception or judgment, lapse in attention or lack of knowledge base. Lack of sleep, pressure to see patients in short notice, and distractions may all impair one’s ability to concentrate and prevent making mistakes. The environment in which physicians practice may lead to errors, as well as having to make decisions on the basis of inaccurate or incomplete information.

 

Case 1

For instance, when an 18-month old child has been brought to a clinic with a runny nose, the doctor in charge administered her with the immunizations due at 18 months for she is otherwise healthy, only to realize later that this patient has been to the clinic the week before and has already received immunizations. In such a case, the error isn’t a great one, that is, no harm would result from this action aside from the discomfort of the unnecessary immunization. An open and honest approach on the doctor’s part in such a case will be most appropriate even if the child’s parents initially become angry but they will have to appreciate the doctor’s candor. But if they find out about the mistake on themselves, they would completely lose their trust.

 

Case 2

Another example indicates a 3 month old baby who has been admitted to the hospital with a newly diagnosed ventricular septal defect. She’s in early congestive heart failure and digoxin is indicated. An order for digoxin has been written by the doctor after a proper dose discussion made with the attending physician, thirty minutes later the baby vomits and then has a cardiac arrest and dies. Later on the doctor finds out that he/she has misplaced the decimal point when writing the digoxin order and the baby has been administered 10 times too much digoxin and died in consequence. A serious error has been made in this case with deep implications for both the patient and the family. The doctor in here, regardless of the lawsuit that may come, has to give an honest explanation to the family for they need to hear how sorry he/she is. Parents are less likely to litigate when the doctor is responsibly honest with them instead of being dishonest, wrong and disrespectful.

 

Case 3

The last example is of a 3 year old diagnosed with pyelonephritis by her physician and treated with an intramuscular injection of antibiotic and has been sent home on an oral antibiotic. The next day she started vomiting and was unable to keep the antibiotic down. In the meantime of admitting the baby, the doctor feels that they were supposed to have admitted this baby yesterday instead and were late. Due to practice of medicine not being an exact science, physicians are often at disagreements about what constitutes the most appropriate management in a given case. Usually, these are legitimate disagreements with more than one acceptable course of action. Just because one doctor could’ve managed the case differently that doesn’t mean the other one has been mistaken all along. In this case the doctor may have discussed the case with the other physician and explained why they manage children with pyelonephritis in a different way. Yet, the parents should not be told that a mistake has been made in cases where standard practice differs.
 

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Prepared By: Dr. Mehyar Al-khashroum
Edited By: Miss Araz Kahvedjian




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