After graduating from medical school, prospective doctors typically enter into a residency program. This portion of medical training takes place at a teaching hospital and lasts anywhere from three to seven years. Normally beginning in late June or July, this is the first time that resident doctors are allowed to make significant medical decisions themselves. While this independence allows doctors to grow and understand the practice of medicine, it can, unfortunately, lead to tragic consequences.
Researchers David Phillips and Gwendolyn Barker of the University of California at San Diego studied the effect that medical residents have on medication errors in a report published in the Journal of General Internal Medicine. Though there have been studies on the so-called "July Effect" before, none had been able to quantify the theory into any meaningful study. Barker and Phillips, however, undertook an exhaustive review of recorded deaths from 1979 to 2006 and turned up nearly 250,000 deaths related to medication errors in a hospital setting.
The data showed a clear trend for the month of July. During this month, the rate of medication errors and related deaths rose nearly 10 percent, corresponding directly to the time when residents begin treating patients on their own. Conversely, when this data was compared to counties without teaching hospitals, this 10 percent spike disappeared.
Common Types of Medication Errors and Injuries
The National Coordinating Council for Medication Error Reporting and Prevention defines a medication error as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer."
Though the study indicates July as having a higher level of medication errors, these errors occur at all times of the year and at all levels of the health care system. Whether an error occurs at the hands of a resident, treating physician, nurse or pharmacist, they happen with alarming frequency. A 2006 study by the Institute of Medicine noted that at least 1.5 million people are injured by medication errors every year.
The American Hospital Association cites the following as common reasons and types of medication errors:
- Incomplete patient information - lack of information on allergies, other medications that patients may be taking, lab results, etc.
- Unavailable drug information - warnings or warning labels that are not up-to-date
- Incorrect drug orders - can be a result of poor handwriting, confusion between drugs with similar names, misuse of zeros or decimal points, confusing metric and other dosing units, and inappropriate abbreviations
- Environmental factors - such as lighting, heat, noise, and interruptions that can distract health professionals from their medical tasks
One of the biggest risks associated with these errors is the risk of accidental overdose. Whether the doctor wrote the prescription incorrectly or miscalculated the amount to be taken by the patient, an increased dosage can be especially dangerous, particularly for the elderly and for very young patients.
Similarly, the failure to determine the appropriate drug to take can have severe consequences. Regardless of the reason, when the wrong drug is prescribed by a doctor, there is an increased risk of complications and allergic reactions. One of the more overlooked aspects of an incorrect prescription is the failure to treat the illness or condition that caused the initial hospitalization, prolonging the stay and costs for the patient.
Patients and Hospitals Can Both Help Prevent Errors
The data reviewed by Barker and Phillips, in some cases, was over three decades old. Over that time period, the practice of medicine and the technology supporting it have evolved significantly. Many hospitals have come to embrace new technologies to reduce medication errors and make the practice of medicine safer. Electronic prescriptions, for example, are becoming more common in hospitals, helping to eliminate mistakes based on poor handwriting. A recent study by Weill Cornell Medical College found that the use of electronic prescriptions can reduce errors by up to seven times their current rate.
One of the best ways patients can protect themselves is to speak directly to their doctor. It is important to find out the correct name, dosage and potential side effects of any medication you will be taking.
There are, of course, instances when it is too late to prevent the injury. In these situations, it is important to work with an experienced attorney who can help you fully recover from your provider's mistakes. These are complicated cases and often require an expert to review documentation and medical reports in order to determine exactly what caused the error and the extent of your injuries.