April 3, 2023

Greetings Professor Fisher,

Today I present to you my data report, Medical Errors and How They Affect You, as assigned March 2, 2023.

The three data figures for this data report were chosen to highlight the different ways in which medical errors can harm a patient.
This includes: 1) physical and emotional harm, 2) the far-reaching and lasting effects such as loss of trust in the medical field and
financial harm, and 3) the most devastating effect of medical errors, death.

The data figures and information contained within this report were pulled from various sources including a few that have a vested
interest in medical errors and how to prevent them. Any follow up can be done through the sources cited. A medical field
background is not necessary as this information is intended to provide the patient with the knowledge of the possible effects of
medical errors and how to help prevent them from happening to themselves or those around them.

I hope that the information included within this report meets your requirements and you are satisfied with the outcome.

Sincerely,

Shaylene Lopez

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" Medical Errors and How They Affect
You."
By: Shaylene Lopez
April 3, 2023

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 “Medical Errors and How They Affect You."
Submitted to Professor Fisher
English 2210:
Professional and Technical Communications

April 3, 2023

By: Shaylene Lopez

Abstract:

This report details the possible impacts as a result of medical errors. The data figures for this report show the different ways that
medical errors harm the patient. The information contained within this report ranges from emotional harm to death. Also included
are various ways to help lessen the potential of medical errors happening to the patient. This report is not intended to dissuade the
patient from seeking necessary medical care, but to make the patient aware of the possible outcomes should a medical error befall
them and what the patient can do to reduce the risk of medical errors occurring to them.

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 Table of Contents
TITLE AND ABSTRACT……………………………………………………………………………………………….………………………………………………..………..……..3

LIST OF FIGURES…………………………………………………………………………………………………….…………………………………………..……………………….5

INTRODUCTION…………………………………………………………………………………………………….……………………………………………………..…..…………6

2.0 MEDICAL ERROR IMPACTS ON PHYSICAL AND EMOTIONAL HEALTH……………….…………………………………………..……………….….……7

2.1 Summary……..…………………………………………………………………………………….…………………………………………..…………...………….7
2.2 Interpretation…….………………………………………………………………..………………………………………………………………………..……..…7

3.0 THE FAR-REACHING EFFECTS OF MEDICAL ERRORS………………………………………...………………………………………...………….………….…..8

3.1 Summary…………………………………………………………………..………………..………………………………………………………..…………………9
3.2 Interpretation………………………………………………………..………………………….……………………………………………………......……..….9

4.0 MEDICAL ERRORS AND DEATH IN THE UNITED STATES………………………………………………………………………………………….…………….10

4.1 Summary……..……………………………………..………………………………………………………………………………………………………….…..…10
4.2 Inerpretation………………………………………………………………………………………….…….………………………..………………………........11

5.0 CONCLUSION …………………………………………………………………………………………………………………..……….………………………………….……..12

REFERENCES…………………………………………………………………………………………………………………………………...............................................13

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 List of Figures

Figure 1. The Financial and Human Cost of Medical Error...And How Massachusetts Can Lead the Way On Patient
Safety…………………….………………………………………………………………………………………………………………………….………………………..………....…..7

Figure 2. The Financial and Human Cost of Medical Error...And How Massachusetts Can Lead the Way On Patient Safety
…………………………………………………………………………………………………………………………………………………………………………………………………….8

Figure 2. Medical Errors Now Third Leading Cause Of Death In United States……………………………………………………………….………..….10

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1.0 Introduction

1.1 Purpose

The information contained within this report provides the patient with the information of how a medical error can impact them and
their family. Section 2.0 covers the impacts on both physical and emotional health due to medical errors. In section 3.0, this report
dives deeper into the effects of medical errors on the patient outside of the physical and emotional health aspect. Finally, in section
4.0 the patient will see the most devastating and horrible consequence of medical errors.

1.2 Background

From the Betsy Lehman Center for Patient Safety’s website:

“Betsy Lehman, a reporter and mother of two young girls, was battling breast cancer. While in the hospital, her care team made a
series of fatal mistakes, giving her four times the intended dose of a powerful chemotherapy drug. Her death at age 39 in
1994 catalyzed a national movement to improve patient safety.”

The Betsy Lehman case brought to light the system-wide failures that were taking place and showed that changes needed to be
made quickly. Currently, with all the advancements that are available within the medical field medical errors should be at an all-time
low, or so one would think. This report includes the different ways that medical errors affect the patient and what can be done to try
and prevent medical errors occurring to them.

1.3 Scope

This report focuses on the effects of medical errors on a patient physically, emotionally, and financially. This report is not meant to
dissuade the patient from seeking necessary medical care, but to show the importance of being their own advocate and to take the
necessary steps needed to protect themself and their loved ones from unnecessary harm and even death.

Note: A medical field background is not needed to understand the information contained within this report.

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2.0 Medical Error Impacts on Physical and Emotional Health

The first piece of data in this medical error presentation comes from The Betsy Lehman Center for Patient Safety. This center is a
non-regulatory state agency with a legislative mandate to do the following per their website:

“Help state health care agencies and providers work as part of a total system of patient safety and meet their responsibilities
to keep patients safe;
Develop new ways for consumers to be included in a statewide program for improving patient safety;
Analyze data and research to support patient safety initiatives;
Administer an education and research program to increase awareness about medical error and error prevention strategies for
health care professionals, facilities, agencies, and the general public; and
Share information about evidence-based practices to enhance patient safety.”

This data was generated for a report that includes two sets of research findings and shows the impacts that medical errors have on
patients.

Figure 3:"The Financial and Human Cost of Medical Error...and How Massachusetts Can Lead the Way on Patient Safety" Betsy
Lehman Center for Patient Safety (2019). https://betsylehmancenterma.gov/assets/uploads/Cost-of-Medical-Error_Executive-
Summary.pdf

2.1 Summary

The information in this data figure suggests that there are long term effects of medical errors on both physical and mental health.
The chart on the left shows the level of impact the medical error had on the patient’s physical health for the time frames of less than
one year and longer than one year. While the chart on the right shows what emotional impacts occurred because of the medical
error and the time in which it affected them in relation to the time of the medical error.

2.2 Interpretation

The biggest takeaway from this data figure is that medical errors not only effect a patient’s physical health but also their emotional
health and can affect them for years to come. The knowledge that medical errors can have little to no effect on a patient physically
or can result in their death is not surprising. The fact that medical errors can emotionally impact a patient years after the error is
both fascinating and disturbing. These charts show that the prevention of medical errors is an issue that should be priority for
anyone in the medical field. This data figure also should remind patients to be their own advocate and control what they can control
to help prevent medical errors.

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3.0 The Far-Reaching Effects of Medical Errors

This data figure also comes from the Betsy Lehman Center for Patient Safety’s report on medical errors. Their report states:

“We identified and interviewed Massachusetts residents who have experienced medical error through two statewide
telephone surveys. First, the Center for Health Information and Analysis’ 2017 Massachusetts Health Insurance Survey, which
reached 5,001 randomly selected households, included a brief set of questions to identify people who had experienced a
medical error in the previous five years in their own care or in the care of a family or household member. A total of 988
people reported medical error experience in the Massachusetts Health Insurance Survey. In 2018, we were able to conduct a
30-question “re-contact survey” with 253 respondents about the physical, emotional, behavioral, and financial impacts of the
errors, as well as the communication and support offered by providers after the errors.”

This data figure compiles the different impacts that the medical errors had on the patients surveyed.

Figure 4:"The Financial and Human Cost of Medical Error...and How Massachusetts Can Lead the Way on Patient Safety" Betsy
Lehman Center for Patient Safety (2019). https://betsylehmancenter.ma.gov/assets/uploads/Cost-of-Medical-Error_Executive-
Summary.pdf

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3.1 Summary

This figure shows the far-reaching effects that medical errors can have. Patients show dissatisfaction with the lack of communication
about an error, patients lose trust in the health care system, patients can suffer long term physical harm from the error and patients
can suffer financial setbacks that can last indefinitely. This figure also shows how many preventable medical errors occurred in just
one year as well as the financial hit the Massachusetts economy took in just one year due to medical errors.

3.2 Interpretation

The biggest takeaway from this data figure is the astounding way that medical errors can affect the patient, the patient’s family, and
the economy. The patients can have long lasting impacts on their physical health along with a financial setback that can follow them
and their family for life. According to the report, "The Financial and Human Cost of Medical Error...and How Massachusetts Can Lead
the Way on Patient Safety" from the Betsy Lehman Center for Patient Safety (2019),

“Overall, we found 61,982 preventable harm events and over $617 million in excess health insurance claims—just above one
percent of the state’s Total Health Care Expenditures.”

This report also states,

“Studies consistently show that patients and families are excellent observers of medical error. In some cases, they are more likely
than their clinicians to detect errors and are correct most of the time when they do report errors. But they are often reluctant to
speak up or come forward out of a fear of offending their clinicians or out of a belief that their concerns won’t be taken seriously
or make a difference.”

This data figure should encourage people to speak up if they notice an error and to not be afraid to speak their mind. They could be
saving their life or someone else’s.

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4.0 Medical Errors and Death in The United States

This last data figure comes from The Washington Post and is from a John Hopkins Medicine study that analyzed medical death rate
data from 2000-2008. This study, which was released in 2016 per a news release on the John Hopkins Medicine site, states:

“In their study, the researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008,
including one by the U.S. Department of Health and Human Services’ Office of the Inspector General and the Agency for
Healthcare Research and Quality. Then, using hospital admission rates from 2013, they extrapolated that based on a total of
35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which the researchers say now translates to 9.5
percent of all deaths each year in the U.S.”

The following data figure shows the top eleven causes of death in the United States based on the findings of the John Hopkins study.

Figure 5: “Medical errors now third leading cause of death in United States.” The Washington Post (2016).
https://www.washingotnpost.com/news/to-your-health/wp/2016/05/05/researchers-medical-errors-now-third-leading-cause-of-
death-in-united-states/

4.1 Summary

This data figure shows the incidence of death due to medical errors in relation to the other top causes of death in the United States.
An article from John Hopkins discussing this reported information was printed in The BMJ on May 3, 2016. The article states:

“Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more
than 250,000 deaths per year are due to medical error in the U.S.”

This number greatly surpasses the U.S. CDC’s third leading cause of death, respiratory disease, which kills almost 150,000 people per
year.

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4.2 Interpretation

This data figure emphasizes how deadly medical errors can truly be. At over 250,000 deaths per year, medical errors are not
something that can nor should be ignored. One of the authors of the John Hopkins study, Dr. Martin Makary defines a death due to
a medical error as the following:

“…one that is caused by inadequately skilled staff, error in judgment or care, a system defect or a preventable adverse effect. This
includes computer breakdowns, mix-ups with the doses or types of medications administered to patients and surgical
complications that go undiagnosed.”

John Hopkins Medicine’s website states in their news release from May 3,2016:

“The researchers caution that most of medical errors aren’t due to inherently bad doctors, and that reporting these errors
shouldn’t be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including
poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition
to unwarranted variation in physician practice patterns that lack accountability.”

The National Institutes of Health website has Joint Commission Patient Safety Goals that include the following:

 Identify patient safety dangers and risks

 Identify patients correctly by confirming the identity in at least two ways
 Improve communication such as getting test results to the correct person quickly
 Prevent infection by hand-cleaning, post-op infection antibiotics, catheter changes, and central line precautions.
 Prevent mistakes in surgery by making sure the correct surgery is done on the correct body part; pause before surgery to
double-check.
 Use device alarms and make sure that alarms on medical equipment are heard and checked quickly.
 Use medications correctly and safely, double-checking labeling and correctly passing on patient medicines to the next
provider.
 Label all medications, even those in a syringe. This should preferably be done in the area where the medications are
prepared.
 Take extra time with patients who have been prescribed anticoagulants and chemotherapeutic agents.
 To prevent nosocomial infections, hand washing should be routine before and after visiting each patient

To help mitigate the risk of medical errors the patient can and should: ask questions, get a second opinion, have their complete
health record with them, bring someone they trust to help understand what is being said, and finally, patients should trust their
instincts and say something if something seems wrong.

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5.0 Conclusion

Medical errors are a fact of life. The likelihood that medical errors will cease to exist one day most likely will never happen. Mistakes
happen, computer systems fail, miscommunication occurs, and sometimes someone just does the wrong thing. Patients should look
to seek treatment from healthcare facilities that place patient safety as a top priority and have the statistics to prove it. To protect
themselves patients should take care to choose a provider that listens to them and communicates with them openly and honestly
and if their provider fails at that, the patient should seek a new provider. The patient should never be afraid to question any doctor,
nurse, or medical assistant in any situation. So many patients feel that they are bothering the doctors and nurses by asking so many
questions and pushing for more tests, opinions and options, but the truth is, by being their own advocate and an advocate for their
children, the patient could potentially save their life or their child’s life one day.

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 References

Betsy Lehman Center for Patient Safety. (2019). The Financial and Human Cost of Medical Error...and How Massachusetts Can
Lead the Way on Patient Safety. Betsy Lehman Center For Patient Safety. Retrieved March 8, 2023, from
https://betsylehmancenterma.gov/assets/uploads/Cost-of-Medical-Error-Executive-Summary.pdf

Cha, A. E. (2021, October 26). Researchers: Medical errors now third leading cause of death in United States. The Washington
Post. Retrieved March 8, 2023, from
https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-
leading-cause-of-death-in-united-states/

Daniel, M. (2016, May 3). Study suggests medical errors now third leading cause of death in the U.S. . Johns Hopkins Medicine,
based in Baltimore, Maryland. Retrieved March 29, 2023, from
https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_o
f_death_in_the_us

Hipskind, J. E. (2022, December 4). Medical Error Reduction and Prevention. National Library of Medicine. Retrieved March 30,
2023, from https://www.ncbi.nlm.nih.gov/books/NBK499956/

Sipherd, R. (2018, February 28). The third-leading cause of death in us most doctors don't want you to know about. CNBC.
Retrieved March 31, 2023, from https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-
america.html

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