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Are we victims of medical error or of an inefficient medical system?
Published in The Saudi Gazette on 27 - 06 - 2014


Dr. Waleed Fetaihi
Al-Watan


What role should the healthcare professional play in the treatment process? When should we blame a professional for a medical error? What is the difference between a medical error and negligence? Under what circumstances should a healthcare professional be held liable?
These questions were raised in 1995 by our public health professor when I was enrolled in a graduate program of healthcare management and law at Harvard University. To answer these questions, the professor cited the case of an ICU nurse who, due to work pressure and fatigue, made a medical error that cost a patient his life. When the professor asked how many students in the class thought the nurse should be fired and held liable, the majority agreed. Two hours later, we agreed that the nurse should not be punished but that the medical system adopted by the hospital should be investigated because it was the system that had made the nurse commit the error.
The lecture was given by Prof. Lucian Leape, known globally as the father of patient safety. He has dedicated two decades of his life to studying medical errors and how to prevent them. Relevant studies and research have proved that the best way to prevent medical error is to study its causes and to change the medical system, a fact that Prof. Leape mentioned over 20 years ago. Therefore, it is the system which should be reevaluated when a medical error happens unintentionally.
A medical error or negligence is defined as an error that happens when a doctor breaches the proper principles and standards of medicine, resulting in injury to a patient or loss of life. On the other hand, side effects, to some degree, are bound to occur during any operation. For example, although the highest standards of sterilization are followed by the best hospitals in the world, 3-4 percent of infections occur during operations. Blood clots are another risk, despite the fact that the patient has been given anticoagulants. Pneumonia may lead to death although the right antibiotic has been administered at the right time and as per proper medical procedures.
There are some errors that take place within the medical system which cannot be blamed on human beings, negligence or expected side effects. Has the punishment mentality, which insists that those who make mistakes should be punished, been helpful in improving patient safety around the world? Let's look at the following statistics:
The Institute of Medicine, founded under the congressional charter of the National Academy of Sciences, published a detailed study in 2013 on the victims of medical errors of which there were 440,000 in the United States alone. In the European Union, the figures are much the same. The statistics of the World Health Organization's Regional Office for Europe showed that the side effects of medical errors in hospitals ranged between 8-12 percent. Changing the medical system in EU hospitals could help prevent 750,000 medical errors a year, according to the statistics.


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