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American Morning

Medical Mistakes

Aired February 05, 2004 - 08:46   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BILL HEMMER, CNN ANCHOR: We are paging Dr. Sanjay Gupta this morning, talking about medical mistakes. First, though, a bit of background for you. The numbers are startling. Every year, it is said, Tens of thousands of Americans die from mistakes by doctors or nurses, operating on wrong patients, prescribing the wrong drugs, even leaving surgical instruments inside patients.
Dr. Robert Wachter has written a book about the problem. It's called "Internal Bleeding." He is our guest here in New York City to talk about these mistakes and what can be done to prevent them. And Sanjay is with us, too. And we'll talk to Sanjay in a moment.

First, this came to your attention because you made a mistake. What happened.

DR. ROBERT WACHTER, AUTHOR, "INTERNAL BLEEDING": That's right, Bill, as a medical student, now 20 years ago, I saw a patient who looked very ill, and I really didn't know what was going on, and I didn't know enough to ask the right questions, and he died in front of me. And it was after that I began to realize that there was a problem here. I thought I was a good and competent doctor, and I have seen there are many good and competent doctors who make these kinds of mistakes.

HEMMER: To be frank with you, this book can scare a lot of people. Those numbers tens of thousands of deaths every year from mistakes, legitimate?

WACHTER: They're the best data we have. And if the numbers are right, they would say in the next 15 minutes, an American will die from a medical error.

It is a terrible problem, and I think as doctors -- I know Sanjay probably feels the same way -- our tendency is to say this is not so bad, we don't want to scare people. And yet, I think until we as a profession own up to a fact that medical care is not as safe as it could be, we are never going to put in the time, and attention and resources we need to fix it.

HEMMER: Take me inside the hospital -- mistakes such as what?

WACHTER: Wrong dose, wrong medicine, huge numbers of fumbles. And by fumbles, I mean, I know something about you, and I am transitioning you as a patient to Dr. Gupta, who is going to take care of you, and the information doesn't make it to him seamlessly, or the patient leaves the hospital to go back to home or to a nursing home, and there is loss of information in both directions. HEMMER: Give me some reassurance. What's done to police this? Anything?

WACHTER: These days a fair amount. Not very much until three or four years ago. A big report came out three on are four years ago that really focused our attention. These days we are working doggedly. So in a hospital like mine -- I'm at University of California, San Francisco -- we are now instituting the checklist, readbacks. A readback is if I call my Chinese restaurant, and I say I'd like hot and sour soup, before I hang up the phone, they say to me, let me read that back to you, just to be sure they don't give me the wonton.

HEMMER: Comes down to basic communication, doesn't it?

WACTHER: Basic communication. We need those sort of things now.

HEMMER: I want him to get a shot at you real quickly. Go ahead, Sanjay.

GUPTA: You know the interesting thing -- you and I both work in hospitals -- ultimately, medicine is a very human profession. You can put the best standards in place, you can have computer barcoding, and all that sort of stuff, these mistakes are still going to happen, correct?

WACHTER: Absolutely. There's going to be some level of mistakes. We're making tough judgment calls every minute, and some of them are going to go the wrong way, but the level of computerization, checkbacks, readbacks, those sort of redundancies that aviation has embraced a long time ago, other industries have decided -- figured out ways to make things safer. We have not put in the time and money to do this. In the book, we talk about that this is sort of like the collateral damage of this high-tech war that we otherwise seem to be winning. In medicine, we do spectacular things. Some of the work that you do in your profession couldn't have been done 20 or 30 years ago, but it's also less safe than it would be, and we can fix this.

HEMMER: He has great insight.

Your patient tips are what, Sanjay?

GUPTA: Well, I'll tell you, first of all, you talk about these sorts of mistakes, and I think both the doctors and the patients have a certain responsibility to try and diminish this. We talked about diminishing them. We talked about this quite a bit, really having the communication between you and are doctor open up, sometimes tape recording your doctor's appointment. Don't be shy to ask your doctor about specifics types of techniques, things like that.

Your doctor's track record, I think, also is important. There have been studies to show that the more procedures that your doctor does, the better success you are going to have. That's common sense.

Second opinions, you know, sometimes a lot of patients sort of shy away from those. Most doctors aren't offended by a second opinion. That's oftentimes a good idea. A lot of times doctors embrace it. Surgical tips -- great book by the way. And you talk about this in your book as well. These are important things. Ask about the latest techniques, since techniques are changing all the time. Sometimes you can get some of that early in the week and early in the day is something that I've heard.

And really sort, I think, if you are going to have your operation, if you can have it earlier in the week and earlier in the day, the risk of error is less, mark your body before surgery. A lot of times nurses do that now. It seems very primitive, to talk about primitive techniques. Don't cut here is sometimes what you see on some of these. Also, know what the best and worst-case scenarios, are, you know, be your own best advocate, I think.

HEMMER: Use judgment and communicate. Talk about it, and especially listen. Ask the right questions. Thank you, Sanjay. See you next hour. Doctor, thanks for sharing. The book is called "Internal Bleeding." Thank you again.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired February 5, 2004 - 08:46   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: We are paging Dr. Sanjay Gupta this morning, talking about medical mistakes. First, though, a bit of background for you. The numbers are startling. Every year, it is said, Tens of thousands of Americans die from mistakes by doctors or nurses, operating on wrong patients, prescribing the wrong drugs, even leaving surgical instruments inside patients.
Dr. Robert Wachter has written a book about the problem. It's called "Internal Bleeding." He is our guest here in New York City to talk about these mistakes and what can be done to prevent them. And Sanjay is with us, too. And we'll talk to Sanjay in a moment.

First, this came to your attention because you made a mistake. What happened.

DR. ROBERT WACHTER, AUTHOR, "INTERNAL BLEEDING": That's right, Bill, as a medical student, now 20 years ago, I saw a patient who looked very ill, and I really didn't know what was going on, and I didn't know enough to ask the right questions, and he died in front of me. And it was after that I began to realize that there was a problem here. I thought I was a good and competent doctor, and I have seen there are many good and competent doctors who make these kinds of mistakes.

HEMMER: To be frank with you, this book can scare a lot of people. Those numbers tens of thousands of deaths every year from mistakes, legitimate?

WACHTER: They're the best data we have. And if the numbers are right, they would say in the next 15 minutes, an American will die from a medical error.

It is a terrible problem, and I think as doctors -- I know Sanjay probably feels the same way -- our tendency is to say this is not so bad, we don't want to scare people. And yet, I think until we as a profession own up to a fact that medical care is not as safe as it could be, we are never going to put in the time, and attention and resources we need to fix it.

HEMMER: Take me inside the hospital -- mistakes such as what?

WACHTER: Wrong dose, wrong medicine, huge numbers of fumbles. And by fumbles, I mean, I know something about you, and I am transitioning you as a patient to Dr. Gupta, who is going to take care of you, and the information doesn't make it to him seamlessly, or the patient leaves the hospital to go back to home or to a nursing home, and there is loss of information in both directions. HEMMER: Give me some reassurance. What's done to police this? Anything?

WACHTER: These days a fair amount. Not very much until three or four years ago. A big report came out three on are four years ago that really focused our attention. These days we are working doggedly. So in a hospital like mine -- I'm at University of California, San Francisco -- we are now instituting the checklist, readbacks. A readback is if I call my Chinese restaurant, and I say I'd like hot and sour soup, before I hang up the phone, they say to me, let me read that back to you, just to be sure they don't give me the wonton.

HEMMER: Comes down to basic communication, doesn't it?

WACTHER: Basic communication. We need those sort of things now.

HEMMER: I want him to get a shot at you real quickly. Go ahead, Sanjay.

GUPTA: You know the interesting thing -- you and I both work in hospitals -- ultimately, medicine is a very human profession. You can put the best standards in place, you can have computer barcoding, and all that sort of stuff, these mistakes are still going to happen, correct?

WACHTER: Absolutely. There's going to be some level of mistakes. We're making tough judgment calls every minute, and some of them are going to go the wrong way, but the level of computerization, checkbacks, readbacks, those sort of redundancies that aviation has embraced a long time ago, other industries have decided -- figured out ways to make things safer. We have not put in the time and money to do this. In the book, we talk about that this is sort of like the collateral damage of this high-tech war that we otherwise seem to be winning. In medicine, we do spectacular things. Some of the work that you do in your profession couldn't have been done 20 or 30 years ago, but it's also less safe than it would be, and we can fix this.

HEMMER: He has great insight.

Your patient tips are what, Sanjay?

GUPTA: Well, I'll tell you, first of all, you talk about these sorts of mistakes, and I think both the doctors and the patients have a certain responsibility to try and diminish this. We talked about diminishing them. We talked about this quite a bit, really having the communication between you and are doctor open up, sometimes tape recording your doctor's appointment. Don't be shy to ask your doctor about specifics types of techniques, things like that.

Your doctor's track record, I think, also is important. There have been studies to show that the more procedures that your doctor does, the better success you are going to have. That's common sense.

Second opinions, you know, sometimes a lot of patients sort of shy away from those. Most doctors aren't offended by a second opinion. That's oftentimes a good idea. A lot of times doctors embrace it. Surgical tips -- great book by the way. And you talk about this in your book as well. These are important things. Ask about the latest techniques, since techniques are changing all the time. Sometimes you can get some of that early in the week and early in the day is something that I've heard.

And really sort, I think, if you are going to have your operation, if you can have it earlier in the week and earlier in the day, the risk of error is less, mark your body before surgery. A lot of times nurses do that now. It seems very primitive, to talk about primitive techniques. Don't cut here is sometimes what you see on some of these. Also, know what the best and worst-case scenarios, are, you know, be your own best advocate, I think.

HEMMER: Use judgment and communicate. Talk about it, and especially listen. Ask the right questions. Thank you, Sanjay. See you next hour. Doctor, thanks for sharing. The book is called "Internal Bleeding." Thank you again.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com