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Patient Safety: How to Avoid Becoming a Victim of Medical Errors

With Doctors:

• When possible, do not use a hospital emergency room for routine medical treatment. The emergency room physician will not have access to or be familiar with your medical history which can lead to medical mistakes.

• If a doctor diagnoses your condition, be sure to ask:

  • What is my diagnosis?
  • What is the technical name of my disease or condition, and what does it mean in plain English?
  • What is my prognosis (outlook for the future)?
  • What changes will I need to make?
  • Is there a chance that someone else in my family might get the same condition?
  • Will I need special help at home for my condition?
  • Is there any treatment?
  • What are my treatment options?
  • How soon do I need to make a decision about treatment?
  • What are the benefits and risks associated with my treatment options?
  • Is there a clinical trial (research study) that is right for me?
  • Will I need any additional tests?
  • What organizations and resources do you recommend for support and information?

• If the doctor suggests treatment, ask:

  • What are my treatment options?
  • What do you recommend?
  • Is the treatment painful?
  • How can the pain be controlled?
  • What are the benefits and risks of this treatment?
  • How much does this treatment cost?
  • Will my health insurance cover the treatment?
  • What are the expected results?
  • When will I see results from the treatment?
  • What are the chances the treatment will work?
  • Are there any side effects?
  • What can be done about them?
  • How soon do I need to make a decision about treatment?
  • What happens if I choose to have no treatment at all?

• If a doctor suggests surgery, ask:

  • Why do I need surgery?
  • What kind of surgery do I need?
  • What will you be doing?
  • What are the benefits and risks of having this surgery?
  • Have you done this surgery before?
  • How successful is this surgery?
  • Which hospital is best for this surgery?
  • Will the surgery hurt?
  • Will I need anesthesia?
  • How long will the surgery take?
  • How long will it take me to recover?
  • How long will I be in the hospital?
  • What will happen after the surgery?
  • How much will the surgery cost?
  • Will my health insurance cover the surgery?
  • Is there some other way to treat my condition?
  • What will happen if I wait or don't have this surgery?
  • Where can I get a second opinion?
• If your doctor suggests surgery, seek a second opinion from a specialist. To ensure a comprehensive treatment plan, obtain opinions from two specialists and have the doctors explain the advantages and risks of the surgery or treatment.
• Ask the specialist how often they perform the surgery they are suggesting.

With a Surgery

• If you decide to have surgery, ask questions about the surgery so you understand what will be done. Do not be afraid to ask questions, no matter how simple they may seem. The doctor is responsible for explaining the procedure so that you can understand it.
• If general anesthesia is administered for your surgery, use a magic marker to highlight the area to be operated on.
• During your hospital stay, have a family member or close friend be there with you as your advocate.

• Make sure you understand what will happen if you need surgery. Be sure you, your doctor, and your surgeon all agree on exactly what will be done during the operation. Ask your doctor who will manage your care when you are in the hospital. Ask your surgeon:

  • Exactly what will you be doing?
  • About how long will it take?
  • What will happen after the surgery?
  • How can I expect to feel during recovery?

With Medications

• Tell all your doctors about every medication you are taking, including prescription medications, over-the-counter medications, and supplements such as vitamins and herbs.
• Tell all your doctors about any allergies and adverse reactions to medications that you have experienced.
• When filling your prescriptions, ensure you are receiving the correct medication. Communication between doctor and pharmacist can breakdown, or pharmacy assistants can make mistakes.
• Ask your pharmacist and doctor about side effects of your medications. Make sure you report all side effects you experience to your doctor and that they are documented in your medical record.

• Questions to ask about your medications:

  • What is the medicine for?
  • How am I supposed to take it, and for how long?
  • What side effects are likely? What do I do if they occur?
  • Is this medicine safe to take with other medicines-both prescription and over-the-counter-or dietary supplements I am taking?
  • What food, drink or activities should I avoid while taking this medicine?
  • Does this new prescription mean I should stop taking any other medicines I'm taking now?

With Contraindications

A contraindication is a specific situation in which a drug, procedure, or surgery should NOT be used, because it may be harmful to the patient. Some treatments may cause unwanted or dangerous reactions in people with allergies, high blood pressure, or pregnancy. For example, certain decongestants are contraindicated in people with high blood pressure and therefore should be avoided. Many medications interact and should not be used together by the same person. For instance, a person who takes Warfarin to thin the blood should not take aspirin.

There are two types of contraindications:

• Partial contraindication means that caution should be used when two drugs or procedures are used together.
• Absolute contraindication means that it could result in a life-threatening situation.

To find out if a physician has had complaints against them, visit:

• DocInfo, a service offered by the Federation of State Medical Boards (FSMB) that provides physician disciplinary information for a fee (approximately $10).
• The Arizona Medical Board provides physician disciplinary information free of charge.

20 Ways You Can Reduce Medical Errors

1. The single most important way you can help to prevent yourself from becoming a victim of a medical error is to become an active member of your health care team.

This means taking part in every decision about your health care. Research shows that patients who are more involved with their health care tend to achieve better, safer results. The rest of the ways to reduce medical errors involve specific tips based on the latest scientific evidence about what works best.

At least once a year, bring all of your medicines and supplements to your doctor. "Brown bagging" medicines can help you and your doctor talk about them and find out if there are any potential problems. It can also help your doctor keep your records up to date, which can help you receive better quality care.

This can help you avoid receiving a medicine that can harm you.

If you can't read your doctor's handwriting, a pharmacist may not be able to either.

5. Ask for information about your medicines in terms you can understand-when medicines are prescribed, and when you receive them:

• What is the medicine for?
• How am I supposed to take it, and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines or dietary supplements I am taking?
• What food, drink, or activities should I avoid while taking this medicine?

6. When you pick up your medicine from the pharmacy, ask them if it is the same medicine that your doctor prescribed.

A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of prescribed medicine errors involved the wrong drug or the wrong dose.

Medicine labels can be hard to understand. For example, ask if "four doses daily" means taking a dose every 6 hours around the clock or only during regular waking hours.

Research shows that many people do not understand the proper way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, such as marked syringes, help people to measure the right dose. Instruction in how to use the devices helps even more.

If you know what might happen, you will be better prepared if it does-or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse. A study found that written information about medicines can help patients recognize problem side effects and relay that information to their doctor or pharmacist.

Research shows that patients tend to experience better results when they are treated in hospitals that have a great deal of experience with their condition.

Hand washing is an important way to prevent the spread of infections in hospitals. Still, it is not done regularly or thoroughly enough. A recent study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap.

This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, doctors think their patients understand more than they really do about what should or should not be done when the patient returns home.

Performing surgery at the wrong site-for example, operating on the left knee instead of the right-is rare. But even one occurrence is once too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery.

You have a right to question anyone who is involved with your health care.

This is especially important if you have many health problems or are in a hospital.

Do not assume that everyone knows everything they need to be aware of.

Even if you think you don't need help at the begining, you may need it later.

It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.

Ask about the results, and don't be afraid to ask questions for clarification.

In the unfortunate event that you, or a family member, should suffer from any form of medical malpractice, contact the Patton Law Practice in Scottsdale, Arizona, and put a strong advocate on your side.